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NPI Code Detail

MEDICARE: AC MICRO GUAM LLC

MEDICARE: AC MICRO GUAM LLC
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
1207L00000XAnesthesiology Physician0633184GU

General Provider Information

NPI Number : 1699768093
Entity Type Code : Organization
Provider Name (Legal Business Name) : AC MICRO GUAM LLC
Provider Business Mailing Address
First Line : 633 GOV CARLOS G CAMACHO RD
Second Line : STE 101 GUAM MEDICAL PLAZA
City : TAMUNING
State : GU
Zip : 96913-3143
Country : US
Telephone Number : 671-646-3855
Fax Number : 671-646-3854
Provider Business Practice Location Address
First Line : 633 GOV CARLOS G CAMACHO RD
Second Line : STE 101 GUAM MEDICAL PLAZA
City : TAMUNING
State : GU
Zip : 96913-3143
Country : US
Telephone Number : 671-646-3855
Fax Number : 671-646-3854
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MELISSA WAIBEL
Credential :
Telephone Number : 671-646-3855
Provider Enumeration Date : 08/31/2005
Last Update Date : 08/10/2020

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Directions to “AC MICRO GUAM LLC ” Practice Location

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