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General NPI Number Information
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NPI Number | 1447747746
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Entity Type | Individual
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Provider Name | SHANTAL NICOLE VILLALOBOS MD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 7157 MARY PECK BOND PL
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City | PITTSBURGH
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State | PA
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Zip | 15206-1236
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Country | US
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Telephone | 412-661-2802
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Fax | 412-661-8020
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Provider Business Mailing Address
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Address Line | 7157 MARY PECK BOND PL
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City | PITTSBURGH
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State | PA
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Zip | 15206-1236
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Country | US
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Telephone | 412-661-2802
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Fax | 412-661-8020
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD474887
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License Number State | PA
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