DR. SANTIAGO MIRO (NPI# 1689859829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689859829 |
Entity Type | Individual |
Full Name | DR. SANTIAGO MIRO |
Credential | B.S., M.D. |
Practice Address |
7302 Wakefield Dr Fayetteville NY 13066-9755 |
Practice Telephone | 5085232584 |
Mailing Telephone | 5085232584 |
Enumeration Date | 2008-01-07 |
Last Update Date | 2015-11-03 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD435000 | PA | Allopathic & Osteopathic Physicians |
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
235173 | MA | Allopathic & Osteopathic Physicians |
N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
MD435000 | PA | Allopathic & Osteopathic Physicians |
N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
235173 | MA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VT | BLUESHIELD | 49887 | 01 |
VT | OVN2555 | 05 |
Street Address |
7302 WAKEFIELD DR |
City | FAYETTEVILLE |
State | NY |
Zip Code | 13066-9755 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
Find all providers in zip 13066 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700211653 | Medical Associates of Northwest Arkansas Pa | Radiology | 3383 N Mana Ct Ste 102, Fayetteville, AR 72703-4965 | 2013-09-11 |
1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
1295858967 | Garney H Fendley | Radiology | 3215 N. North Hills Blvd, Fayetteville, AR 72703-4424 | 2007-04-09 |
1558424986 | Joseph Vincent Scrivani | Radiology | 5436 Springview Dr, Fayetteville, NY 13066-9678 | 2006-12-18 |
1538244751 | Bernard Schneider | Radiology | 7064 Woodchuck Hill Rd, Fayetteville, NY 13066-9764 | 2006-10-26 |
1023190097 | Andrew Bostaph | Radiology | 3027 Hampton Ridge Rd, Fayetteville, NC 28311-3005 | 2006-10-19 |
1326095639 | Cynthia Evette P Humphries | Radiology | 2053 Loganberry Dr, Fayetteville, NC 28304-0804 | 2006-05-30 |
1134170160 | Medical Associates of Northwest Arkansas Pa | Radiology | 55 W Sunbridge Dr, Fayetteville, AR 72703-1825 | 2006-05-15 |
1669430971 | Carolina Imaging LLC of Fayetteville | Radiology | 3628 Cape Center Dr, Fayetteville, NC 28304-4406 | 2006-05-03 |
1114993292 | Jennifer A. Knutsen | Radiology | 513 Briar Brook Run, Fayetteville, NY 13066-8751 | 2006-02-27 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 13066 |
Please comment or provide details below to improve the information on DR. SANTIAGO MIRO.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.