Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD22932 | OR |
NPI | 1023069481 |
---|---|
Provider Name | Michael E Villano |
First Address | Bend, OR 97701-4189 |
Second Address | Bend, OR 97701-6752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 26/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H34798 | (02) | OR |