Healthcare Provider Details

I. General information

NPI: 1902148778
Provider Name (Legal Business Name): CLAY ROBERT GUEITS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

IV. Provider business mailing address

3535 MARKET ST
PHILADELPHIA PA
19104-3309
US

V. Phone/Fax

Practice location:
  • Phone: 866-785-8537
  • Fax:
Mailing address:
  • Phone: 215-746-7248
  • Fax: 215-746-7248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD476514
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: