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NPI Code Detail

MEDICARE: JACQUELINE E SANTAMARINA MD

MEDICARE: JACQUELINE E SANTAMARINA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2024033433MO
2208000000XPediatrics Physician2024033433MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548887896
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE E SANTAMARINA MD
Provider Business Mailing Address
First Line : 54 HOSPITAL DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3050
Country : US
Telephone Number : 573-348-8000
Fax Number : 573-302-2297
Provider Business Practice Location Address
First Line : 54 HOSPITAL DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3050
Country : US
Telephone Number : 573-348-8000
Fax Number : 573-302-2297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2020
Last Update Date : 01/08/2026

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Directions to “ JACQUELINE E SANTAMARINA MD” Practice Location

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