Provider Demographics
NPI:1861788192
Name:VALLADOLID, GENARO FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:GENARO
Middle Name:FRANCISCO
Last Name:VALLADOLID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GENARO
Other - Middle Name:FRANCISCO
Other - Last Name:VALLADOLID MUNGUIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:545 BARNHILL DR
Mailing Address - Street 2:EMERSON HALL, STE 232
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5112
Mailing Address - Country:US
Mailing Address - Phone:317-278-0394
Mailing Address - Fax:
Practice Address - Street 1:545 BARNHILL DR
Practice Address - Street 2:EMERSON HALL, STE 232
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5112
Practice Address - Country:US
Practice Address - Phone:317-278-0394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58065208200000X
IL125.059987208600000X
IN01076801A208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery