Organization
GUAT SY JR MD PC
Active
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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