De Villa, Maria D

De Villa, Maria D is an individual health care provider with primary practice located at 1580 Commanche Ave , Green Bay WI 54313-5751. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is her primary health care specialty. De Villa, Maria D can be contacted via phone (920) 435-8326.

Contact Information

Primary practice address
1580 Commanche Ave Green Bay WI 54313-5751
Phone: (920) 435-8326
Fax: (920) 430-4659
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 24698 Nebraska
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 65835-20 Wisconsin

Profile Details

NPI number 1538321252
LBN Legal business name De Villa, Maria D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2008
Last updated Sep 18th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538321252 NPPES
Wisconsin MEDICAID 100057118
Wisconsin Other P01669360

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