ROBERTO CANDELARIA-SANTIAGO (NPI# 1790051134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790051134 |
| Entity Type | Individual |
| Full Name | ROBERTO CANDELARIA-SANTIAGO |
| Credential | M.D. |
| Practice Address |
Mamc Dept of Pathology 9040 Fitzsimmons Dr Joint Base Lewis Mcchord WA 98431-1000 |
| Practice Telephone | 2539685025 |
| Mailing Telephone | 2539685025 |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2017-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
27995 | NE | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 27995 | NE | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
MAMC DEPT OF PATHOLOGY 9040 FITZSIMMONS DR |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98431-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255757886 | Salvatore Emmanuele Mignano | Pathology | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431 | 2014-03-06 |
| 1982965802 | Richard Louis Thomas | Pathology | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316367857 | Paul Dennis Simonson | Pathology | Uwmc Anatomic Pathology, 1959 Ne Pacific, Box 356100, Seattle, WA 98195-0001 | 2014-04-23 |
| 1629413109 | Paula Marie Jenkins Colon | Pathology | Uw Medicine Pathology 1959 Ne Pacific St, Box 357470, Seattle, WA 98195-0001 | 2013-05-09 |
| 1104167550 | Pakc-dsl Inc Ps | Pathology | 550 17th Ave., Ste. 300, Seattle, WA 98122 | 2013-03-11 |
| 1265799407 | Elizabeth Bagnulo Dacey | Pathology | 1225 Highland Avenue, Clarkston, WA 99403 | 2012-04-12 |
| 1295001436 | Robert Farrell Kapela | Pathology | 5652 132nd Ave Ne, Bellevue, WA 98005-1033 | 2012-03-30 |
| 1790070571 | Marc Omar Shokeir | Pathology | 336 36th St, 320, Bellingham, WA 98225-6580 | 2011-06-09 |
| 1801190186 | Malcolm Scott Stirton | Pathology | 6347 Beach Dr Sw, Seattle, WA 98136-1351 | 2010-12-31 |
| 1962721258 | John Fowler | Pathology | 9049 Jackson Ave, Tacoma, WA 98431-1000 | 2010-05-26 |
| 1063730745 | Bup-jong Jennifer Kum | Pathology | 1124 Columbia St # 8320, Seattle, WA 98104 | 2010-05-05 |
| 1770727638 | John Dallas Scarborough | Pathology | 2202 S Cedar St Ste 340, Tacoma, WA 98405-2318 | 2009-04-22 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98431 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.