Individual
VICTOR ADALBERT GERALDEZ DE VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
720 S VANBUREN ST, SUITE 104, GREEN BAY, WI 54301-3538
(920) 433-6050
(920) 433-6049
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
24449
NE
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301114122
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026133000
—
NE
05
—
10026169400
—
NE
01
—
P00705495
RAILROAD MEDICARE
NE
Enumeration date
04/29/2008
Last updated
03/05/2019
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