MEDICARE: DIANA GUERRERO BETANCOURT 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	207R00000X	Internal Medicine Physician	4301406079	MI

General Provider Information

NPI Number	:	1477546059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA GUERRERO BETANCOURT MD

Provider Business Mailing Address
First Line	:	6520 CASTLEBURY DR
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-2711
Country	:	US
Telephone Number	:	248-561-3692
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 WILLIAM CARLS DR
Second Line	:	HURON VALLEY SINAI HOSPITAL
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-2201
Country	:	US
Telephone Number	:	248-937-3300
Fax Number	:

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

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	08/21/2013

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