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General NPI Number Information
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NPI Number | 1154139731
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Entity Type | Individual
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Provider Name | RAMON VILLARUEL VILLANUEVA
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Gender | Male
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 24333 ORCHARD LAKE RD STE A
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-1976
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Country | US
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Telephone | 248-893-7322
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Fax | 248-893-7479
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Provider Business Mailing Address
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Address Line | 7233 PROVINCIAL CT
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City | CANTON
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State | MI
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Zip | 48187-2121
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Country | US
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Telephone | 734-720-2117
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Fax | 734-404-5292
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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