Healthcare Provider Details

I. General information

NPI: 1942438254
Provider Name (Legal Business Name): ADRIAN MANUEL CUELLAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 02/14/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL GUAM FARENHOLT AVENUE, BLDG 50
AGANA HEIGHTS GU
96910
US

IV. Provider business mailing address

U.S. NAVAL HOSPITAL GUAM PSC 455 BOX 208
FPO AP
96540
US

V. Phone/Fax

Practice location:
  • Phone: 671-344-9340
  • Fax:
Mailing address:
  • Phone: 671-344-9340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25882
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA116491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: