Organization
CENTRAL WYOMING NEUROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELO M. SANTIAGO M.D. (OWNER)
(307) 234-9037
Entity
Organization
Contact information
Practice address
5820 E.2ND ST., CASPER, WY 82609-4308
(307) 234-9037
(307) 234-9042
Mailing address
5820 E.2ND ST., CASPER, WY 82609-4308
(307) 234-9037
(307) 234-9042
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5622A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05674001
BCBS OF WY
WY
05
—
120297900
—
WY
Enumeration date
06/30/2006
Last updated
12/07/2015
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