| Dr Enrique Villa Marana, MD | |
|
3485 N Main St, Farmville, NC 27828-1466 | |
| (252) 753-3193 | |
| (252) 753-7966 |
| Full Name | Dr Enrique Villa Marana |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 3485 N Main St, Farmville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497717342 | NPI | - | NPPES |
| 89126A3 | Medicaid | NC | |
| 126A3 | Other | NC | BLUE CROSS BLUE SHIELD |
| P00379704 | Other | NC | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | 200000090 (North Carolina) | Secondary |
| 207Q00000X | Family Medicine | 20000090 (North Carolina) | Primary |
| Entity Name | Farmville Internal Medicine Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710942610 PECOS PAC ID: 8325037575 Enrollment ID: O20040511001545 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Enrique Villa Marana, MD 3485 N Main St, Farmville, NC 27828-1466 Ph: (252) 753-3193 | Dr Enrique Villa Marana, MD 3485 N Main St, Farmville, NC 27828-1466 Ph: (252) 753-3193 |
Dr. Natalie Michelle Malpass, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3681 N Main St, Farmville, NC 27828 Phone: 252-753-7141 | |
Dr. Tyler Scott Moore, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 3681 N Main St, Farmville, NC 27828 Phone: 252-753-7141 |