=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639106990
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAUDIO GUARESCHI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2006
-----------------------------------------------------
Last Update Date | 05/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1506 SPRING ST
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-4071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-725-7900
-----------------------------------------------------
Fax | 864-725-7910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 VINECREST CT # 500
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-8031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-725-7900
-----------------------------------------------------
Fax | 864-725-7910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208G00000X
-----------------------------------------------------
Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
-----------------------------------------------------
License Number | 22656
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------