MEDICARE: SUSAN MAPES GUERINO L.AC., M.AC.

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	171100000X	Acupuncturist	U01058	MD

General Provider Information

NPI Number	:	1841314176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MAPES GUERINO L.AC., M.AC.

Provider Business Mailing Address
First Line	:	29 WELLSPRING DR
Second Line	:
City	:	BEAR
State	:	DE
Zip	:	19701-1360
Country	:	US
Telephone Number	:	302-832-7459
Fax Number	:

Provider Business Practice Location Address
First Line	:	9170 STATE ROUTE 108 STE 202
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-1917
Country	:	US
Telephone Number	:	410-730-2700
Fax Number	:

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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