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General NPI Number Information
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NPI Number | 1396254298
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Entity Type | Individual
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Provider Name | JOHN A GUY
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Gender | Male
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 201 E UNIVERSITY PKWY
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City | BALTIMORE
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State | MD
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Zip | 21218-2829
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Country | US
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Telephone | 410-261-6316
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 FOX RUN
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City | FAIRFAX
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State | VA
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Zip | 22030-5949
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA0025
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License Number State | DC
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