MEDICARE: MARIA GUERMAN

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	225700000X	Massage Therapist	M05270	MD

General Provider Information

NPI Number	:	1326647793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA GUERMAN

Provider Business Mailing Address
First Line	:	2503 BALTIMORE RD APT 7
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20853-2411
Country	:	US
Telephone Number	:	240-447-0989
Fax Number	:

Provider Business Practice Location Address
First Line	:	6171 EXECUTIVE BLVD
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-3901
Country	:	US
Telephone Number	:	240-447-0989
Fax Number	:

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

Provider Enumeration Date	:	10/18/2020
Last Update Date	:	10/18/2020

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