Healthcare Provider Details

I. General information

NPI: 1124512793
Provider Name (Legal Business Name): GIANNA GUZZARDO VALENTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GIANNA MARIA GUZZARDO MD

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN ST
DETROIT MI
48201-2196
US

IV. Provider business mailing address

3901 BEAUBIEN ST
DETROIT MI
48201-2196
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-5515
  • Fax: 313-745-5237
Mailing address:
  • Phone: 313-745-5515
  • Fax: 313-745-5237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number4301505225
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: