Individual
DR. MARIE DENISE ALFONSO GUANZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(701) 530-7000
(701) 530-8842
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(701) 530-7000
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
53336
MN
207R00000X
Internal Medicine Physician
Primary
53336
MN
208M00000X
Hospitalist Physician
9430
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13077
—
ND
01
—
P00327845
RR MEDICARE
ND
Enumeration date
01/18/2006
Last updated
04/28/2011
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