Provider Demographics
NPI:1255393575
Name:VILLIARD, PAUL M (MS, PA-C)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:VILLIARD
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Gender:M
Credentials:MS, PA-C
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Mailing Address - Street 1:5315 ELLIOTT DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-8634
Mailing Address - Country:US
Mailing Address - Phone:734-572-4500
Mailing Address - Fax:734-572-4529
Practice Address - Street 1:5315 ELLIOTT DR
Practice Address - Street 2:SUITE 301
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8634
Practice Address - Country:US
Practice Address - Phone:734-572-4500
Practice Address - Fax:734-572-4529
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2016-06-14
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Provider Licenses
StateLicense IDTaxonomies
MI5601005390363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical