| Doctor Name: | DR. MANUEL SANTOS VILLAREAL |
| NPI Number: | 1255389409 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 35070669 |
| Business Practice Address: | 2300 Chamber Center Dr Suite 102 Lakeside Park, KY - 410171673 |
| Business Phone Number: | 8593713797 |
| Business Fax Number: | 8592911438 |
| Mailing Address: | 2300 Chamber Center Dr, Suite 102 LAKESIDE PARK |
| State: | KY |
| Postal Code: | 410171673 |
| Phone Number: | 8593713797 |
| Fax Number: | 8592911438 |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 10/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RA0201X |
| License Number: | 35070669 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Allergy & Immunology |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. |