Individual
DR. ENRIQUE GUILLERMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6019 WALNUT STREET, MEMPHIS, TN 38120
(901) 226-3010
(901) 226-1707
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-4706
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
27942
TN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
E0557
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122634
—
MS
01
—
3158388
BLUE CROSS
TN
05
—
3832055
—
TN
01
—
P00232048
RAILROAD MEDICARE
TN
Enumeration date
06/05/2006
Last updated
08/27/2019
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