MEDICARE: DOUGLAS ROBERT GUGGER 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	207L00000X	Anesthesiology Physician	MD451343	PA
2	208VP0014X	Interventional Pain Medicine Physician	MD451343	PA
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD451343	PA

General Provider Information

NPI Number	:	1457470429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS ROBERT GUGGER MD

Provider Business Mailing Address
First Line	:	1840 SOUTH ST STE 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-7422
Country	:	US
Telephone Number	:	215-893-7246
Fax Number	:	215-243-4615

Provider Business Practice Location Address
First Line	:	1840 SOUTH ST STE 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-7422
Country	:	US
Telephone Number	:	215-893-7246
Fax Number	:	215-243-4615

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	10/24/2019

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