MEDICARE: DANZHU 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	208100000X	Physical Medicine & Rehabilitation Physician	43199	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	250012454	OTHER	WI	RAILROAD

General Provider Information

NPI Number	:	1366470551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANZHU 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	:	920-288-8377
Fax Number	:	920-288-8385

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/09/2024

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Directions to “ DANZHU GUO MD” Practice Location

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