Healthcare Provider Details

I. General information

NPI: 1023513934
Provider Name (Legal Business Name): CYNTHIA MICHELLE GUERIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2018
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE STE 1500
ATLANTA GA
30308-2248
US

IV. Provider business mailing address

550 PEACHTREE ST NE STE 1500
ATLANTA GA
30308-2248
US

V. Phone/Fax

Practice location:
  • Phone: 404-897-6810
  • Fax: 770-388-9715
Mailing address:
  • Phone: 404-897-6810
  • Fax: 770-388-9715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number111903
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.152687
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number111903
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: