Individual
XAIMARIE SANTIAGO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3655 MITCHELL ST, LORIS, SC 29569-2827
(843) 716-7000
Mailing address
4000 HIGHWAY 9 E, LITTLE RIVER, SC 29566-7833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
83903
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2017
Last updated
08/17/2021
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