MEDICARE: DR. JOHNSTUART M GUARNIERI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	0101041390	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00108974	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	292271	OTHER	VA	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	480669	OTHER	VA	MDIPA
5	27607	OTHER	VA	SENTARA
6	450470381	OTHER	SC	TRICARE

General Provider Information

NPI Number	:	1215025200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNSTUART M GUARNIERI MD

Provider Business Mailing Address
First Line	:	333 MCLAWS CIR
Second Line	:	SUITE 3
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-6339
Country	:	US
Telephone Number	:	757-345-2275
Fax Number	:	757-229-3435

Provider Business Practice Location Address
First Line	:	333 MCLAWS CIR
Second Line	:	SUITE 3
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-6339
Country	:	US
Telephone Number	:	757-345-2275
Fax Number	:	757-229-3435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	01/30/2009

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