Individual
JASON A SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-2416
(260) 436-9662
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
01088176A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
05/14/2025
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