Organization
SANTIAGO MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL A FUENTES M.D. (PRESIDENT)
(401) 312-0444
Entity
Organization
Contact information
Practice address
967 MINERAL SPRING AVENUE, NORTH PROVIDENCE, RI 02904-4934
(401) 312-0444
Mailing address
967 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-4934
(401) 312-0444
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
07/15/2009
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