Healthcare Provider Details

I. General information

NPI: 1922270347
Provider Name (Legal Business Name): ANNA MARIA VILLALOBOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 MEMORIAL AVE SUITE 10
LYNCHBURG VA
24501-2661
US

IV. Provider business mailing address

2323 MEMORIAL AVE SUITE 10
LYNCHBURG VA
24501-2661
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-5200
  • Fax: 434-200-5213
Mailing address:
  • Phone: 434-200-5200
  • Fax: 434-200-5213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101255743
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMC-0124
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18364
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-45721
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number64696
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60908477
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number57513
License Number StateAZ
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD22683
License Number StateME
# 9
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11024386-1205
License Number StateUT
# 10
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11405
License Number StateSD
# 11
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16019
License Number StateND
# 12
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCDRH.0056481
License Number StateCO
# 13
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberCDRH.0056481
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: