Manuel Bunoan Villanueva, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11992 Issued in WV

Practice address

6070 Robert C Byrd Drive
Bradley, WV 25818

Phone

(304) 877-2600

Fax

(304) 877-2600

NPI assigned

Oct 4, 2006

Last updated

Feb 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Manuel B. Villanueva M.D., P.C.

  • Family Medicine Physician
  • Bradley, WV
  • NPI 1457532632
  Authorized official Same address or phone

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1861587990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "address_2": "DRAWER 329",
            "city": "BRADLEY",
            "state": "WV",
            "postal_code": "25818",
            "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 DRIVE",
            "city": "BRADLEY",
            "state": "WV",
            "postal_code": "25818",
            "telephone_number": "304-877-2600",
            "fax_number": "304-877-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "MANUEL",
        "middle_name": "BUNOAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "11992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "MA9195181",
            "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
• Manuel B. Villanueva M.D., P.C.
• Suzanne Marie Parkulo
• Tori Robin Walker

• Family Medicine Physician in Bradley, WV
• Providers in Bradley, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.