Provider Demographics
NPI:1295058758
Name:VILLANUEVA, MARIA SOPHIA S (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA SOPHIA
Middle Name:S
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA SOPHIA
Other - Middle Name:L
Other - Last Name:SUBONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 CAMPUS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6906
Mailing Address - Country:US
Mailing Address - Phone:540-536-3470
Mailing Address - Fax:540-536-3471
Practice Address - Street 1:400 CAMPUS BLVD STE 210
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6906
Practice Address - Country:US
Practice Address - Phone:540-536-3470
Practice Address - Fax:540-536-3471
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101273219208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery