MEDICARE: MIGUEL SANTAULARIA TOMAS M.D.

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	207RC0000X	Cardiovascular Disease Physician	5472230	ZZ
2	208D00000X	General Practice Physician	4008395	ZZ

General Provider Information

NPI Number	:	1922259308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL SANTAULARIA TOMAS M.D.

Provider Business Mailing Address
First Line	:	3900 N CHARLES ST
Second Line	:	APARTMENT 306
City	:	BALTIMORE
State	:	MD
Zip	:	21218-1756
Country	:	US
Telephone Number	:	443-938-0928
Fax Number	:	410-502-3539

Provider Business Practice Location Address
First Line	:	720 RUTLAND AVE
Second Line	:	JOHNS HOPKINS UNIVERSITY ROSS BUILDING, ROOM 1044
City	:	BALTIMORE
State	:	MD
Zip	:	21205-2109
Country	:	US
Telephone Number	:	410-502-2505
Fax Number	:	410-502-2529

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

Provider Enumeration Date	:	10/03/2008
Last Update Date	:	10/03/2008

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Directions to “ MIGUEL SANTAULARIA TOMAS M.D.” Practice Location

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