Organization
PHYSICIAN AT HOME, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH A. SANTIAGO M.D. (PRESIDENT)
(413) 563-7534
Entity
Organization
Contact information
Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(413) 563-7534
Mailing address
820 67TH AVE N, P.O. BOX 70157, MYRTLE BEACH, SC 29572-0200
(413) 563-7534
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
34596
SC
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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