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General NPI Number Information
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NPI Number | 1851967095
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Entity Type | Individual
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Provider Name | JOSE CHIQUINQUIRA MUNOZ VILLASMIL MD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 2244 ASHLEY CROSSING DR UNIT 1232
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City | CHARLESTON
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State | SC
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Zip | 29414-6161
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Country | US
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Telephone | 832-759-0253
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Fax | 843-792-9295
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Provider Business Mailing Address
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Address Line | 169 ASHLEY AVE RM 202
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City | CHARLESTON
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State | SC
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Zip | 29425-8905
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Country | US
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Telephone | 843-792-2575
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Fax | 843-792-9295
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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 | 86047
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License Number State | SC
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