| Manuel B. Villanueva M.d., P.c. | |
|
6070 Robert C Byrd Dr Bradley WV 25818 | |
| (304) 877-2600 | |
| (304) 877-2600 |
| Full Name | Manuel B. Villanueva M.d., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 6070 Robert C Byrd Dr, Bradley, West Virginia |
| Authorized Official Name and Position | Manuel B. Villanueva (OWNER) |
| Authorized Official Contact | 3048772600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manuel B. Villanueva M.d., P.c. Po Box 265 Bradley WV 25818-0265 Ph: (304) 877-2600 | Manuel B. Villanueva M.d., P.c. 6070 Robert C Byrd Dr Bradley WV 25818 Ph: (304) 877-2600 |
| NPI Number | 1457532632 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457532632 | NPI | - | NPPES |
| 410013738 | Other | WV | RAILROAD MEDICARE |
| 0056004000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11992 (West Virginia) | Primary |