MEDICARE: MRS. CERES A GUZMAN-MORALES M.D.

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	208000000X	Pediatrics Physician	4301035267	MI

General Provider Information

NPI Number	:	1285631184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CERES A GUZMAN-MORALES M.D.

Provider Business Mailing Address
First Line	:	44199 DEQUINDRE RD
Second Line	:	SUITE 222
City	:	TROY
State	:	MI
Zip	:	48085-1128
Country	:	US
Telephone Number	:	248-879-5570
Fax Number	:	248-879-2235

Provider Business Practice Location Address
First Line	:	44199 DEQUINDRE RD
Second Line	:	SUITE 222
City	:	TROY
State	:	MI
Zip	:	48085-1128
Country	:	US
Telephone Number	:	248-879-5570
Fax Number	:	248-879-2235

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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