| Robert Santiago, Md, Inc. | |
|
396 Portland Way N Galion OH 44833-1115 | |
| (419) 462-5543 | |
| (419) 462-2058 |
| Full Name | Robert Santiago, Md, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 396 Portland Way N, Galion, Ohio |
| Authorized Official Name and Position | Dianne Santiago (CO-OWNER) |
| Authorized Official Contact | 6144318869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Santiago, Md, Inc. 247 Glen Village Ct Powell OH 43065-9677 Ph: (614) 431-8869 | Robert Santiago, Md, Inc. 396 Portland Way N Galion OH 44833-1115 Ph: (419) 462-5543 |
| NPI Number | 1578731972 |
|---|---|
| Provider Enumeration Date | 02/19/2008 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 4981898566 |
|---|---|
| Medicare Enrollment ID | O20101027000964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578731972 | NPI | - | NPPES |
| 35-05-7517 | Other | OH | OHIO MEDICAL LICENSE |
| $$$$$$$$$ | Other | SSN | |
| 0759362 | Medicaid | OH | |
| 107669 | Other | OH | WORKER'S COMP. EMPL. RISK |
| 1720121213 | Other | INDIVIDUAL (TYPE 1) NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 35-05-7517 (Ohio) | Primary |
| Provider Name | Robert Santiago |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720121213 PECOS PAC ID: 5890989479 Enrollment ID: I20101027001021 |
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