MEDICARE: DR. PEGGY J. GUERRERO-MARTIN M.D.

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	208000000X	Pediatrics Physician	D0050253	MD

General Provider Information

NPI Number	:	1891759890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEGGY J. GUERRERO-MARTIN M.D.

Provider Business Mailing Address
First Line	:	6722 FAIT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-3003
Country	:	US
Telephone Number	:	410-633-8445
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 OLD ANNAPOLIS RD
Second Line	:	SUITE 101
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6314
Country	:	US
Telephone Number	:	410-992-9339
Fax Number	:	410-964-5150

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	07/09/2007

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