Individual
NELSON V SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
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
Update your record
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