Individual
VIDMAR IVAN CARRILLO GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21444 CARMEAN WAY, GEORGETOWN, DE 19947-4572
(302) 855-1233
(302) 654-1061
Mailing address
21444 CARMEAN WAY, GEORGETOWN, DE 19947-4572
(302) 855-1233
(302) 654-1061
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
LG-0013919
DE
Other
Enumeration date
06/04/2026
Last updated
06/04/2026
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