MEDICARE: CHRISTOPHER M SANTANGELO PA-C

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
1	363AS0400X	Surgical Physician Assistant	238	WV

General Provider Information

NPI Number	:	1578647418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER M SANTANGELO PA-C

Provider Business Mailing Address
First Line	:	3703 TEAYS VALLEY RD
Second Line	:
City	:	HURRICANE
State	:	WV
Zip	:	25526-9645
Country	:	US
Telephone Number	:	304-757-2273
Fax Number	:	304-760-9290

Provider Business Practice Location Address
First Line	:	3703 TEAYS VALLEY RD
Second Line	:
City	:	HURRICANE
State	:	WV
Zip	:	25526-9645
Country	:	US
Telephone Number	:	304-760-9250
Fax Number	:	304-760-9290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	12/30/2015

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