Individual
DR. JEROME MATTHEW GUANCIALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
332 2ND AVE N, WAHPETON, ND 58075-4528
(701) 642-7000
(701) 642-7055
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 312-9802
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0393
SC
208600000X
Surgery Physician
Primary
17750
ND
208600000X
Surgery Physician
70737
MN
208600000X
Surgery Physician
DO2175
NV
Other
Enumeration date
04/13/2006
Last updated
04/29/2022
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