Individual
DR. MARK CARROLL GUERDAN
Active
Individual
DR. MARK CARROLL GUERDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
31403
KY
207L00000X
Anesthesiology Physician
Primary
61081
GA
207L00000X
Anesthesiology Physician
62257
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
061081
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
61081
GA
208VP0000X
Pain Medicine Physician
61081
GA
208VP0014X
Interventional Pain Medicine Physician
061081
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135345A
—
GA
05
—
003135346A
—
GA
Enumeration date
06/09/2006
Last updated
07/14/2014
Update your record
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