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General NPI Number Information
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NPI Number | 1093877854
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Entity Type | Organization
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Legal Business Name | ROBERTO M.VILLASENOR MD PA
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 916 MIDDLEFORD RD
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City | SEAFORD
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State | DE
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Zip | 19973-3604
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Country | US
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Telephone | 302-629-7605
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Fax | 302-629-2323
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Provider Business Mailing Address
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Address Line | 916 MIDDLEFORD RD
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City | SEAFORD
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State | DE
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Zip | 19973-3604
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Country | US
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Telephone | 302-629-7605
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Fax | 302-629-2323
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERTO VILLASENOR
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Credential | MD
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Telephone | 302-629-7605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C10001573
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License Number State | DE
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