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Organization

GUAT SY JR MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GUAT SIA SY JR. MD (PRESIDENT)
(313) 271-2990
Entity
Organization

Contact information

Practice address
17000 HUBBARD DR, STE 700, DEARBORN, MI 48126-4205
(313) 271-2990
(313) 271-1698
Mailing address
17000 HUBBARD DR, STE 700, DEARBORN, MI 48126-4205
(313) 271-2990
(313) 271-1698

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301040071
MI
208C00000X
Colon & Rectal Surgery Physician
Primary
4301040071
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020H237340
BCN GROUP
MI
05
1780686469
MI
05
2929938-10
MI
01
4079900
AETNA
MI
01
B45647
HAP
MI
01
DP0095
RAILROAD MEDICARE
MI
Enumeration date
08/12/2005
Last updated
08/07/2009
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