| Edgar Santillan MD LLC | |
|
2400 Miami Valley Dr Centerville OH 45459-4774 | |
| (937) 556-4324 | |
| (937) 439-3786 |
| Full Name | Edgar Santillan MD LLC |
|---|---|
| Speciality | Hospitalist |
| Location | 2400 Miami Valley Dr, Centerville, Ohio |
| Authorized Official Name and Position | Edgar R Santillan (OWNER) |
| Authorized Official Contact | 9375564324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgar Santillan MD LLC Po Box 771861 Detroit MI 48277-1861 Ph: (937) 556-4324 | Edgar Santillan MD LLC 2400 Miami Valley Dr Centerville OH 45459-4774 Ph: (937) 556-4324 |
| NPI Number | 1114325321 |
|---|---|
| Provider Enumeration Date | 12/22/2014 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Medicare PECOS PAC ID | 5193041614 |
|---|---|
| Medicare Enrollment ID | O20150227001270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114325321 | NPI | - | NPPES |
| 0117021 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35075548 (Ohio) | Secondary |
| 208M00000X | Hospitalist | 35075548 (Ohio) | Primary |
| Provider Name | Edgar Roberto Santillan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902823867 PECOS PAC ID: 6507837044 Enrollment ID: I20040805001335 |
Primed Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6520 Acro Court, Centerville, OH 45459 Phone: 937-291-6830 Fax: 937-291-6893 |
Primed Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 979 Congress Park Dr, Centerville, OH 45459 Phone: 937-435-9013 Fax: 937-435-1458 |
Pioneer Health Associates, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9223 Great Lakes Cir, Centerville, OH 45458 Phone: 937-912-9428 |
South Dayton Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6611 Clyo Rd, Suite C, Centerville, OH 45459 Phone: 937-208-8288 Fax: 937-208-8286 |
Bellbrook Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6438 Wilmington Pike, Suite110, Centerville, OH 45459 Phone: 937-848-4121 Fax: 937-848-5965 |
Sesslar Family Medical Center, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6627 Centerville Business Pkwy, Centerville, OH 45459 Phone: 937-312-9212 Fax: 937-312-0742 |