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Manuel B. Villanueva M.D., P.C.

Family Medicine in Bradley, WV. Organization (NPI-2).

NPI number1457532632
StatusActive
Last updated in NPPESMay 22, 2008

Details

NPI
1457532632
Entity type
Organization (NPI-2)
Legal business name
Manuel B. Villanueva M.D., P.C.
Organization subpart
No
Enumeration date
Nov 16, 2007
Last updated
May 22, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine11992WVYes

Practice location

6070 Robert C Byrd Dr
Bradley, WV 25818

Phone 304-877-2600 · Fax 304-877-2600

Mailing address

Po Box 265
Bradley, WV 25818-0265

Phone 304-877-2600 · Fax 304-877-2600

Authorized official

Manuel B. Villanueva
Owner
3048772600

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