Provider Demographics
NPI:1033641287
Name:SANTIAGO, KARL CHRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:CHRISTIAN
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MADELYN LN STE B
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4460
Mailing Address - Country:US
Mailing Address - Phone:207-301-5600
Mailing Address - Fax:207-301-5360
Practice Address - Street 1:7 MADELYN LN STE B
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4460
Practice Address - Country:US
Practice Address - Phone:207-301-5600
Practice Address - Fax:207-301-5360
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD24103208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics