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Individual

DR. MANUEL SANTOS VILLAREAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2300 CHAMBER CENTER DR STE 102, LAKESIDE PARK, KY 41017-1686
(859) 781-4900
(859) 572-3039
Mailing address
2830 VICTORY PKWY, CINCINNATI, OH 45206-1785
(513) 585-5504
(513) 585-5511

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
35070669
OH
207KA0200X
Allergy Physician
30879
KY
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
30879
KY
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
35 070669
OH
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
35070669
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
35070669
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000001005
CHA INSURANCE
KY
01
000000033648
ANTHEM
KY
01
0220092
UNITED HEALTH CARE
KY
01
138180523662
HUMANA INS CO
KY
05
200518220
IN
05
2064564
OH
01
610715494
OTHER INSURANCE COMPANIES
KY
05
64308794
KY
01
650439
AETNA
KY
Enumeration date
05/04/2006
Last updated
04/30/2018
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