Basic Information
| Provider Information | |||||||||
| NPI: | 1073826095 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTIANO | ||||||||
| FirstName: | MARCOS | ||||||||
| MiddleName: | ANGELO | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31150 HUNTLEY SQ E | ||||||||
| Address2: | APT 1712 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480255339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053891035 | ||||||||
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| Practice Location | |||||||||
| Address1: | 28050 GRAND RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483365919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484718822 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2010 | ||||||||
| LastUpdateDate: | 07/19/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5101018987 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.