Provider Demographics
NPI:1285079723
Name:MORALES-SANTIAGO, ANGEL B (MD)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:B
Last Name:MORALES-SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:EMORY UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - Street 2:615 MICHAEL STREET, SUITE 201
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-727-5596
Mailing Address - Fax:404-727-5767
Practice Address - Street 1:1600 MEDICAL WAY STE 270
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2209
Practice Address - Country:US
Practice Address - Phone:770-972-4780
Practice Address - Fax:770-972-2371
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR18841207R00000X, 390200000X
GA86159207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program