Individual
DR. AMELIA J. SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
202 LARRY JOE HARLESS DRIVE, SUITE 205, GILBERT, WV 25621-1842
(304) 664-6270
(304) 664-6272
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5804
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12861
WV
208000000X
Pediatrics Physician
21670
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112321000
—
WV
05
—
65920951
—
KY
Enumeration date
06/20/2006
Last updated
03/01/2013
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