Individual
LUIS NICOLAS VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1121 SOMERVILLE RD SE, SUITE 1, DECATUR, AL 35601-3256
(256) 340-5185
(256) 301-3870
Mailing address
930 FRANKLIN ST SE, HUNTSVILLE, AL 35801-4312
(256) 539-4080
(256) 539-4099
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17898
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009942432
—
AL
05
—
120427
—
AL
01
—
511-07728
BCBS
AL
01
—
51540532
BCBS
AL
01
—
F046
MEDICARE GROUP NPI
AL
Enumeration date
01/10/2006
Last updated
08/23/2010
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