Individual
DR. SANTIAGO MIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S., M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101254528
VA
2085R0202X
Diagnostic Radiology Physician
235173
MA
2085R0202X
Diagnostic Radiology Physician
MD435000
PA
2085R0204X
Vascular & Interventional Radiology Physician
235173
MA
2085R0204X
Vascular & Interventional Radiology Physician
27887
WV
2085R0204X
Vascular & Interventional Radiology Physician
MD435000
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689859829
—
VA
05
—
1689859829
—
WV
01
—
49887
BLUESHIELD
VT
05
—
982902400
—
MD
Enumeration date
01/07/2008
Last updated
03/09/2021
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