Individual
GUAT SIA SY JR.
Active
Individual
GUAT SIA SY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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