Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 35070669 | OH |
N | 207KA0200X | Allergist | 30879 | KY |
Y | 207RA0201X | Internist - Allergy & Immunology | 30879 | KY |
N | 207RA0201X | Internist - Allergy & Immunology | 35 070669 | OH |
N | 207RA0201X | Internist - Allergy & Immunology | 35070669 | OH |
N | 207RG0300X | Geriatric Medicine | 35070669 | OH |
NPI | 1255389409 |
---|---|
Provider Name | Dr. Manuel Santos Villareal |
First Address | Cincinnati, OH 45206-1785 |
Second Address | Lakeside Park, KY 41017-1686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 30/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000001005 | CHA INSURANCE (01) | KY |
000000033648 | ANTHEM (01) | KY |
0220092 | UNITED HEALTH CARE (01) | KY |
138180523662 | HUMANA INS CO (01) | KY |
200518220 | (05) | IN |
2064564 | (05) | OH |
610715494 | OTHER INSURANCE COMPANIES (01) | KY |
64308794 | (05) | KY |
650439 | AETNA (01) | KY |
F08606 | (02) | KY |