Individual
DR. SANTIAGO MIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S., M.D.
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-8750
Mailing address
PO BOX 880, LIMA, OH 45802-0880
(866) 482-5419
(419) 223-2726
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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