Individual
NELSON V SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2425 TAYLOR RD, CHESAPEAKE, VA 23321-2201
(757) 215-1800
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001338
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970026091
MEDICARE RAILROAD
—
Enumeration date
08/30/2006
Last updated
03/22/2022
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