Individual
DR. MICHAEL J. GUILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
88 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 578-1761
(605) 578-1121
Mailing address
88 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 578-1761
(605) 578-1121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
148
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9200452
—
SD
Enumeration date
05/24/2006
Last updated
09/13/2010
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