Individual
MIQUEL ANGEL SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1845 CHERRY ST, MONTGOMERY, AL 36107-2613
(334) 263-2301
(334) 263-0886
Mailing address
PO BOX 70365, MONTGOMERY, AL 36107-0365
(334) 420-5001
(334) 420-0146
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
7279
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51004314
BCBS
AL
05
—
630900003
—
AL
01
—
P00192500
RAILROAD
AL
Enumeration date
07/26/2006
Last updated
03/05/2014
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