1831779016 NPI number — DR. PAOLA MARIA GALAN VILLAR MD

Table of content: DR. PAOLA MARIA GALAN VILLAR MD (NPI 1831779016)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831779016 NPI number — DR. PAOLA MARIA GALAN VILLAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALAN VILLAR
Provider First Name:
PAOLA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831779016
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950244
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40295-0244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-953-4700
Provider Business Mailing Address Fax Number:
502-772-8189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
834 E BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40204-1072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-583-1981
Provider Business Practice Location Address Fax Number:
502-996-8309
Provider Enumeration Date:
04/12/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 59360 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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