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General NPI Number Information
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NPI Number | 1447344825
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Entity Type | Individual
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Provider Name | LUELLA M GUZMAN MD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 611 SHERMAN AVE E
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City | FORT ATKINSON
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State | WI
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Zip | 53538-1960
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Country | US
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Telephone | 920-563-5571
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | FORT ATKINSON
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State | WI
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Zip | 53538-0249
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Country | US
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Telephone | 920-563-4466
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Fax | 920-568-4004
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G151934
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 74002-20
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License Number State | WI
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