Manuel B. Villanueva M.D., P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11992 Issued in WV

Legal business name

MANUEL B. VILLANUEVA M.D., P.C.

Practice address

6070 Robert C Byrd Dr
Bradley, WV 25818

Phone

(304) 877-2600

Fax

(304) 877-2600

NPI assigned

Nov 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Manuel B. Villanueva, M.D.

Title

Owner

Phone

(304) 877-2600

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1457532632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "BRADLEY",
            "state": "WV",
            "postal_code": "258180265",
            "telephone_number": "304-877-2600",
            "fax_number": "304-877-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 ROBERT C BYRD DR",
            "city": "BRADLEY",
            "state": "WV",
            "postal_code": "25818",
            "telephone_number": "304-877-2600",
            "fax_number": "304-877-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL B. VILLANUEVA M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-877-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410013738",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056004000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Price Adkins
• Bradley Prosperity Volunteer Fire Department Inc
• Patricia Evans
• Suzanne Marie Parkulo
• Manuel Bunoan Villanueva, MD
• Tori Robin Walker

• All providers in Bradley, WV
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.