Healthcare Provider Details

I. General information

NPI: 1184662967
Provider Name (Legal Business Name): MARCO A GUERRERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON STREET - MS 11102M HEALTHPARTNERS REGIONS SPECIALTY CLINICS
ST. PAUL MN
55101-2502
US

IV. Provider business mailing address

8170 33RD AVE S # MS 21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-4887
  • Fax: 651-254-1603
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number37632
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: