Individual
LUIS L. VILLARRUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9301 E 59TH ST, INDIANAPOLIS, IN 46216-2236
(317) 964-7064
(317) 964-7087
Mailing address
10614 TENNISON DR, INDIANAPOLIS, IN 46236-8392
(317) 826-0962
(317) 826-0962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030281A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000475865
ANTHEM PIN#
IN
05
—
100325900
—
IN
05
—
200311740
—
IN
01
—
4392375
AETNA PIN#
IN
Enumeration date
04/20/2006
Last updated
05/23/2013
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