Provider Demographics
NPI:1205830247
Name:VILELA, OSWALDO E (MD)
Entity Type:Individual
Prefix:
First Name:OSWALDO
Middle Name:E
Last Name:VILELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 NAVARRE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3298
Mailing Address - Country:US
Mailing Address - Phone:419-697-4281
Mailing Address - Fax:419-697-4283
Practice Address - Street 1:2737 NAVARRE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3298
Practice Address - Country:US
Practice Address - Phone:419-697-4281
Practice Address - Fax:419-697-4283
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-045519V207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0566525Medicaid
OHC02834Medicare UPIN
OH0566525Medicaid