NPI 1154777183

Desiree Santiago

Practitioner Preferred Provider Organization Birmingham, MI

Practice location

Address: 517 Graten St, Birmingham, MI 48009-6519
Phone: (248) 952-4011
Fax: (248) 282-0455

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence AS820379695 (MI)

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Registry record

NPI: 1154777183
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 May 2016
Record last updated: 9 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.