Individual
HONGTAO MICHAEL GUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157
(336) 716-2255
(336) 716-9016
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-9016
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2006-01250
NC
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
2006-01250
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10385130
—
VA
01
—
143GN
BCBS
—
01
—
191653
MEDCOST
—
05
—
3810010511
—
WV
05
—
5906368
—
NC
01
—
7017897
AETNA
—
01
—
808426
PARTNERS
—
05
—
Q0140H
—
SC
Enumeration date
09/15/2006
Last updated
11/15/2010
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