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Individual

LUELLA M GUZMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 563-5571
Mailing address
PO BOX 249, FORT ATKINSON, WI 53538-0249
(920) 563-4466
(920) 568-4004

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
74002-20
WI
208000000X
Pediatrics Physician
G151934
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447344825
VA
05
1447344825
WI
05
1516609
TN
05
21385301
NM
Enumeration date
10/03/2006
Last updated
12/17/2025
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