Healthcare Provider Details

I. General information

NPI: 1164756995
Provider Name (Legal Business Name): AMY MICHELLE GUZEK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2009
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 S TRENT POINT WAY
BOISE ID
83712-8590
US

IV. Provider business mailing address

1545 S TRENT POINT WAY
BOISE ID
83712-8590
US

V. Phone/Fax

Practice location:
  • Phone: 602-684-1562
  • Fax:
Mailing address:
  • Phone: 602-684-1562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number46102
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: