Individual
LOUIS PAUL GUALDONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1802 BRAEBURN DR, SUITE 1310, SALEM, VA 24153-7357
(540) 776-2020
(540) 776-2017
Mailing address
PO BOX 277730, ATLANTA, GA 30384-7730
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110840653
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010400856
—
VA
01
—
P00453910
RAILROAD MEDICARE
VA
Enumeration date
11/16/2005
Last updated
04/25/2008
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