Organization
EDGAR SANTILLAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR R SANTILLAN MD (OWNER)
(937) 556-4324
Entity
Organization
Contact information
Practice address
2400 MIAMI VALLEY DR, CENTERVILLE, OH 45459-4774
(937) 556-4324
(937) 439-3786
Mailing address
PO BOX 771861, DETROIT, MI 48277-1861
(937) 556-4324
(937) 350-6477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35075548
OH
208M00000X
Hospitalist Physician
Primary
35075548
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117021
—
OH
Enumeration date
12/22/2014
Last updated
03/23/2023
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