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Individual

MICHAEL J GUZMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-4206
(317) 880-0557
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01068934A
IN
208C00000X
Colon & Rectal Surgery Physician
Primary
01068934A
IN
390200000X
Student in an Organized Health Care Education/Training Program
01068934A
IN
390200000X
Student in an Organized Health Care Education/Training Program
036134991
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201105520
IN
Enumeration date
07/06/2008
Last updated
01/18/2021
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