MEDICARE: DR. PATRICK A VILLANI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	PV025256	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508864794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK A VILLANI M.D.

Provider Business Mailing Address
First Line	:	19701 VERNIER RD
Second Line	:	SUITE #170
City	:	HARPER WOODS
State	:	MI
Zip	:	48225-1491
Country	:	US
Telephone Number	:	313-885-3800
Fax Number	:	313-885-1121

Provider Business Practice Location Address
First Line	:	19701 VERNIER RD
Second Line	:
City	:	HARPER WOODS
State	:	MI
Zip	:	48225-1467
Country	:	US
Telephone Number	:	313-885-3800
Fax Number	:	313-885-1121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/21/2008

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