# GUAM UROLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497281687
- **Authorized official:** ANN FENTON M.D. (PHYSICIAN OWNER)
- **Authorized official phone:** (671) 646-8765

## Contact information

- **Practice address:** 633 GOV CARLOS G CAMACHO RD, \#104, TAMUNING, GU 96913-3194
- **Practice address phone:** (671) 646-8765
- **Practice address fax:** (671) 646-8763
- **Mailing address:** 633 GOV CARLOS G CAMACHO RD, \#104, TAMUNING, GU 96913-3194
- **Mailing address phone:** (671) 646-8765
- **Mailing address fax:** (671) 646-8763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | M-1855 | GU | Yes |

## Other

- **Enumeration date:** 05/07/2017
- **Last updated:** 05/07/2017