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Individual

DR. EDWIN VILLAMATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2200 KERNAN DR, BALTIMORE, MD 21207-6665
(410) 328-6720
Mailing address
PO BOX 132, STEVENSON, MD 21153-0132
(410) 321-4535

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D42622
MD
207L00000X
Anesthesiology Physician
MD423862
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50050046
RR MEDICARE #
MD
01
CA8702
RR GROUP #
MD
Enumeration date
03/15/2006
Last updated
12/27/2023
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