MEDICARE: DR. DAVID MARTIN GUYETTE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	42990	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437121720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MARTIN GUYETTE M.D.

Provider Business Mailing Address
First Line	:	600 MAIN ST
Second Line	:
City	:	MALDEN
State	:	MA
Zip	:	02148-3919
Country	:	US
Telephone Number	:	781-321-6463
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 MAIN ST
Second Line	:
City	:	MALDEN
State	:	MA
Zip	:	02148-3919
Country	:	US
Telephone Number	:	781-321-6463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	05/29/2012

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