Individual
DR. ESBERDADO S VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 POLARIS PKWY, SUITE 1, COLUMBUS, OH 43240-4042
(614) 847-1120
(614) 847-1205
Mailing address
PO BOX 710725, COLUMBUS, OH 43271-0725
(440) 274-5035
(440) 716-8608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-100307
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224603
ANTHEM
OH
05
—
0282484
—
OH
Enumeration date
03/17/2006
Last updated
11/19/2009
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