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NPI Code Detail

MEDICARE: MR. ARIEL ARCEO ISMAEL MD

MEDICARE: MR. ARIEL ARCEO ISMAEL 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
12084P0804XChild & Adolescent Psychiatry PhysicianM001393GU
22084P0800XPsychiatry PhysicianM001393GU

General Provider Information

NPI Number : 1457557167
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ARIEL ARCEO ISMAEL MD
Provider Business Mailing Address
First Line : 790 GOV CARLOS G CAMACHO RD
Second Line :
City : TAMUNING
State : GU
Zip : 96913-3129
Country : US
Telephone Number : 671-647-5345
Fax Number : 671-647-0191
Provider Business Practice Location Address
First Line : 790 GOV CARLOS G CAMACHO RD
Second Line :
City : TAMUNING
State : GU
Zip : 96913-3129
Country : US
Telephone Number : 671-647-5345
Fax Number : 671-647-0191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 01/04/2022

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