Healthcare Provider Details

I. General information

NPI: 1841848462
Provider Name (Legal Business Name): HEROLDO PALOMARES GUZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ALABAMA AVE SE
WASHINGTON DC
20032-4542
US

IV. Provider business mailing address

1100 ALABAMA AVE SE STE 238
WASHINGTON DC
20032-4542
US

V. Phone/Fax

Practice location:
  • Phone: 202-299-5100
  • Fax:
Mailing address:
  • Phone: 202-299-5334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD210003185
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: