Individual
DR. ENRIQUE DE LA GUARDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6000
Mailing address
217 S 169TH CIR, OMAHA, NE 68118-3041
(402) 331-4257
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16722
NE
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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