Individual
DR. ANGELO M SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
5820 EAST 2ND ST, CASPER, WY 82609
(307) 234-9037
(307) 234-9042
Mailing address
5820 EAST 2ND ST, CASPER, WY 82609
(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
05
—
115004900
—
WY
01
—
313140
BCBS
WY
01
—
P00152272
RAILROAD MEDICARE
WY
Enumeration date
06/27/2006
Last updated
01/31/2008
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