Provider Demographics
NPI:1285608091
Name:SANTOS, MAGDALENA CRUZ (MD)
Entity type:Individual
Prefix:MISS
First Name:MAGDALENA
Middle Name:CRUZ
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1401 W LOCUST ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-3217
Mailing Address - Country:US
Mailing Address - Phone:918-696-4065
Mailing Address - Fax:918-696-5971
Practice Address - Street 1:1401 W LOCUST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3217
Practice Address - Country:US
Practice Address - Phone:918-696-4065
Practice Address - Fax:918-696-5971
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2009-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK21041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK$$$$$$$$$Medicare PIN
OKG95289Medicare UPIN