Individual
TESHA ANN GUILLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(404) 501-1000
Mailing address
PO BOX 1457, BLUEFIELD, WV 24701
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
75804
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
GA
Enumeration date
04/09/2012
Last updated
08/02/2017
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