Ida Mary Santiago-Maldonado, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101058066 Issued in VA

Practice address

2817 Reilly Road MCXC-Cod Credentials
Womack Army Medical Center
Fort Bragg, NC 28310

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Feb 23, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dr. Ida Mary S-M-Lopez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114993896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD MCXC-COD CREDENTIALS",
            "address_2": "WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD MCXC-COD CREDENTIALS",
            "address_2": "WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-MALDONADO",
        "first_name": "IDA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101058066",
            "primary": true
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IDA",
            "last_name": "S-M-LOPEZ",
            "middle_name": "MARY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Bernice Sanders, PA
• Joanna Gloria Sanford, PA-C
• Pablo Santander, MD
• Amy Chen Santangelo, MD
• James Richard Santangelo, MD
• Jenna Sanzone, DO
• Teresa Anita Sapp, PHARMD
• Joseph Michael Sarnelle, DDS
• Paulo A Sarriabarona, D.M.D
• Romeo Satsatin, PA-C

• Internal Medicine Physician in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.