Individual
MR. TIMOTHY ANDREW SANTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1110 PROFESSIONAL CT, HAGERSTOWN, MD 21740-5826
(240) 420-5559
(240) 420-3786
Mailing address
PO BOX 790058, SAINT LOUIS, MO 63179-0058
(636) 549-2380
(314) 569-5974
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
244446
NY
367500000X
Certified Registered Nurse Anesthetist
49407
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
R176827
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23333
AANA CERTIFICATION
—
05
—
419264800
—
MD
01
—
KBC1CH
CAREFIRST BCBS
MD
01
—
P00745069
RR MEDICARE (GRP PTAN DD6120)
MD
01
—
S417-0026
CAREFIRST BCBS
DC
Enumeration date
01/11/2006
Last updated
05/03/2010
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