Provider Demographics
NPI:1558360214
Name:VILLARREAL, YVONNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:M
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:14 SECRETARIAT DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-6671
Mailing Address - Country:US
Mailing Address - Phone:540-286-3729
Mailing Address - Fax:540-286-2929
Practice Address - Street 1:385 GARRISONVILLE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1545
Practice Address - Country:US
Practice Address - Phone:540-657-1223
Practice Address - Fax:540-657-1220
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2010-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101230416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080007787Medicare PIN
VAG94938Medicare UPIN