Healthcare Provider Details

I. General information

NPI: 1801292818
Provider Name (Legal Business Name): MARY ELIZABETH GUINAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 RAMSGATE DR
HENDERSON NV
89074-6131
US

IV. Provider business mailing address

2235 RAMSGATE DR
HENDERSON NV
89074-6131
US

V. Phone/Fax

Practice location:
  • Phone: 702-617-6011
  • Fax:
Mailing address:
  • Phone: 702-617-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number8922
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: