Provider Demographics
NPI:1083194690
Name:SANTIAGO, STELL PATADJI (MD)
Entity Type:Individual
Prefix:MRS
First Name:STELL
Middle Name:PATADJI
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STELL
Other - Middle Name:DARELLE
Other - Last Name:PATADJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9203
Mailing Address - Street 2:64 MEDICAL CENTER DRIVE
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506
Mailing Address - Country:US
Mailing Address - Phone:917-963-0872
Mailing Address - Fax:
Practice Address - Street 1:3550 TERRACE STREET A711 SCAIFE HALL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-802-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD459576207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology