Individual
GUAT SIA SY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17000 HUBBARD DR, SUITE 700, DEARBORN, MI 48126-4258
(313) 271-2990
(313) 271-1698
Mailing address
17000 HUBBARD DR, SUITE 700, DEARBORN, MI 48126-4258
(313) 271-2990
(313) 271-1698
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301040071
MI
208C00000X
Colon & Rectal Surgery Physician
Primary
4301040071
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020010746
RAILROAD MEDICARE
MI
01
—
0208269691
BCBS PIN
MI
05
—
1114929791
—
MI
05
—
2929938-10
—
MI
01
—
4079900
AETNA
MI
01
—
B45647
HAP
MI
01
—
P00753351
RAILROAD MEDICARE
MI
Enumeration date
08/12/2005
Last updated
11/02/2009
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