Provider Demographics
NPI:1649212200
Name:VILLIER, JEAN JOEL (MD)
Entity type:Individual
Prefix:MR
First Name:JEAN
Middle Name:JOEL
Last Name:VILLIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12816 ODENS BEQUEST DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5614
Mailing Address - Country:US
Mailing Address - Phone:240-463-3579
Mailing Address - Fax:
Practice Address - Street 1:4017 MINNESOTA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3541
Practice Address - Country:US
Practice Address - Phone:202-388-9202
Practice Address - Fax:202-388-9209
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD252222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC142969Medicare ID - Type UnspecifiedPROVIDER NUMBER