MEDICARE: GUILLERMO MARQUEZ MD

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	207X00000X	Orthopaedic Surgery Physician	100372	GA
2	207X00000X	Orthopaedic Surgery Physician	25MA12664200	NJ
3	207XP3100X	Pediatric Orthopaedic Surgery Physician	MD489726	PA
4	207X00000X	Orthopaedic Surgery Physician	MD489726	PA
5	207X00000X	Orthopaedic Surgery Physician	94-10061	KS
6	207XP3100X	Pediatric Orthopaedic Surgery Physician	25MA12664200	NJ

General Provider Information

NPI Number	:	1902467418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMO MARQUEZ MD

Provider Business Mailing Address
First Line	:	200 ST LUKES LN STE 200
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6218
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ST LUKES LN STE 200
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6218
Country	:	US
Telephone Number	:	484-526-1735
Fax Number	:

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

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	10/28/2025

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