Provider Demographics
NPI:1154139731
Name:VILLANUEVA, RAMON VILLARUEL
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:VILLARUEL
Last Name:VILLANUEVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7233 PROVINCIAL CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2121
Mailing Address - Country:US
Mailing Address - Phone:734-720-2117
Mailing Address - Fax:734-404-5292
Practice Address - Street 1:24333 ORCHARD LAKE RD STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1976
Practice Address - Country:US
Practice Address - Phone:248-893-7322
Practice Address - Fax:248-893-7479
Is Sole Proprietor?:No
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker