Individual
DR. DOUGLAS LEWIS VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 E B ST, IRON MOUNTAIN, MI 49801-3411
(906) 774-2990
(906) 774-5950
Mailing address
212 EAST B ST, IRON MOUNTAIN, MI 49801
(906) 774-2990
(906) 774-5950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301044982
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080007579
RAILROAD MEDICARE
—
05
—
1631523
—
MI
05
—
30637100
—
WI
Enumeration date
09/07/2006
Last updated
09/08/2011
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