Individual
DR. CAMILO SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 289-6381
(765) 448-7646
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101237102
VA
208600000X
Surgery Physician
Primary
01081449A
IN
208600000X
Surgery Physician
47614
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540392
MEDICARE
IN
05
—
300021456
—
IN
Enumeration date
03/29/2006
Last updated
02/16/2023
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