Individual
DR. 04GLORIA VILLANUEVA DE LA CRUZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 RODMAN AVE, PORTSMOUTH, VA 23707-3100
(757) 399-6192
(757) 393-2124
Mailing address
500 RODMAN AVE, PORTSMOUTH, VA 23707-3100
(757) 399-6192
(757) 393-2124
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101025660
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6715770
—
VA
Enumeration date
03/22/2006
Last updated
07/09/2007
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