Provider Demographics
NPI:1760549075
Name:VILCEUS, ANTENOR PIERRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTENOR
Middle Name:PIERRE
Last Name:VILCEUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANTENOR
Other - Middle Name:P
Other - Last Name:VILCEUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-718-7224
Mailing Address - Fax:336-718-7598
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-718-7224
Practice Address - Fax:336-718-7598
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1812952084V0102X
NC2019-025422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF75799Medicare UPIN