MEDICARE: DANQING GUO 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	207Q00000X	Family Medicine Physician	49655	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	WI1698001	OTHER	WI	PTAN

General Provider Information

NPI Number	:	1245330869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANQING GUO MD

Provider Business Mailing Address
First Line	:	1035 KEPLER DR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-8320
Country	:	US
Telephone Number	:	920-490-9046
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 HOLMGREN WAY
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54304-5224
Country	:	US
Telephone Number	:	920-497-0003
Fax Number	:	920-497-0024

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	04/09/2024

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