Villavicencio, Raphael

Villavicencio, Raphael is an individual health care provider with primary practice located at 1481 W 10Th St Medicine Service, 111, Indianapolis IN 46202-2803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Villavicencio, Raphael can be contacted via phone (317) 554-0000.

Contact Information

Primary practice address
1481 W 10Th St Medicine Service, 111 Indianapolis IN 46202-2803
Phone: (317) 554-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 01051969A Indiana

Profile Details

NPI number 1780643627
LBN Legal business name Villavicencio, Raphael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Dec 3rd, 2010 - about 15 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 1780643627 NPPES
Indiana MEDICAID 200300450
Indiana Other 9397565
Indiana Other 000000351160

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