Provider Demographics
NPI:1922103118
Name:VILLEMAIRE, RONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:VILLEMAIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6 SOMMERSET VALE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4113
Mailing Address - Country:US
Mailing Address - Phone:831-644-9830
Mailing Address - Fax:831-372-5840
Practice Address - Street 1:245 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2409
Practice Address - Country:US
Practice Address - Phone:831-372-2273
Practice Address - Fax:831-372-5840
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC43371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C433710Other1B
CA00C433710Other1H
CA770471127Other24
CA00C433710Other1A
CAC43371Other0B
CA00C433710Other1A
CA00C433711Medicare PIN
CA00C433710Medicare PIN