Provider Demographics
NPI:1386632099
Name:SANTINO, LAUREL JOZWIAK (MD)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:JOZWIAK
Last Name:SANTINO
Suffix:
Gender:F
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:740-653-5088
Mailing Address - Fax:740-653-6361
Practice Address - Street 1:1532 WESLEY WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7642
Practice Address - Country:US
Practice Address - Phone:740-653-5088
Practice Address - Fax:740-653-6361
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.074551207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2073438Medicaid
OHSA0855311Medicare PIN
OH2073438Medicaid