Provider Demographics
NPI:1376510883
Name:SANTIAGO, ARTEMIO CAPILI (MD)
Entity Type:Individual
Prefix:
First Name:ARTEMIO
Middle Name:CAPILI
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5409 AVE O
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FORT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627
Mailing Address - Country:US
Mailing Address - Phone:319-372-7270
Mailing Address - Fax:319-372-7279
Practice Address - Street 1:5409 AVE O
Practice Address - Street 2:SUITE 107
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-9601
Practice Address - Country:US
Practice Address - Phone:319-372-7270
Practice Address - Fax:319-372-7279
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20740207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA13885Medicaid
421324159OtherHUMANA GOLD
421324159OtherUNITED HEALTH CARE
42132415901OtherJOHN DEERE HEALTH CARE
421324159OtherWAUSAU
421324159OtherAETNA
421324159OtherSTANDARD LIFE
421324159OtherAPWU
IA793111317OtherPALMETTO GBA
421324159OtherBANKERS LIFE & CASUALTY
421324159OtherNATL ASSC LETTER CARRIERS
421324159OtherTRI CARE
13885OtherWELLMARK BCBS IA
421324159OtherSECURE HORIZONS
421324159TOtherBLUE SHIELD OF ILLINOIS
13885Medicare PIN
42132415901OtherJOHN DEERE HEALTH CARE