Mirko Villanueva, MD
Internal Medicine in Ann Arbor, MI. Individual provider (NPI-1).
NPI number1174589501
StatusActive
Last updated in NPPESDec 11, 2013
Details
- NPI
- 1174589501
- Entity type
- Individual (NPI-1)
- Name
- Mirko Villanueva
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 25, 2006
- Last updated
- Dec 11, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 4301073838 | MI | Yes |
| 207R00000X | Internal Medicine | 17917 | MS |
Practice location
1500 East Medical Center Dr7th Floor Med Inn
Ann Arbor, MI 48109-5845
Phone 734-936-9068
Mailing address
3621 S State St700 Kms Place
Ann Arbor, MI 48108
Phone 734-936-2047
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