Individual
MR. DAMEK SANTIAGO MAURICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
CHRISTUS ST. VINCENT REGIONAL MEDICAL CENTER, 455 ST. MICHAELS DRIVE, SANTA FE, NM 87505
(505) 913-3934
Mailing address
1640 OLD PECOS TRL STE H, SANTA FE, NM 87505-4777
(505) 992-0233
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A225519
NM
390200000X
Student in an Organized Health Care Education/Training Program
63756
NY
Other
Enumeration date
05/23/2014
Last updated
07/26/2019
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