Provider Demographics
NPI:1124297437
Name:SANTIAGO-SANCHEZ, MICHELALDEMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELALDEMAR
Middle Name:
Last Name:SANTIAGO-SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71325
Mailing Address - Street 2:SUITE 64
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8425
Mailing Address - Country:US
Mailing Address - Phone:787-282-2525
Mailing Address - Fax:
Practice Address - Street 1:892 CALLE 45 SE
Practice Address - Street 2:REPARTO METROPOLITANO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1815
Practice Address - Country:US
Practice Address - Phone:787-282-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine