Provider Demographics
NPI:1730132440
Name:ARRUFFAT, SANTIAGO (MD)
Entity Type:Individual
Prefix:
First Name:SANTIAGO
Middle Name:
Last Name:ARRUFFAT
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 1:950 S KENMORE DR STE B
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-7513
Mailing Address - Country:US
Mailing Address - Phone:812-301-8110
Mailing Address - Fax:812-401-4001
Practice Address - Street 1:950 S KENMORE DR STE B
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-7513
Practice Address - Country:US
Practice Address - Phone:812-301-8110
Practice Address - Fax:812-401-4001
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062345208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100011090Medicaid
IN01062345AOtherSTATE LICENSE
IN000000488625OtherANTHEM BC/BS
IN200824950Medicaid
KY7100011090Medicaid
IN01062345AOtherSTATE LICENSE