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NPI Code Detail

MEDICARE: ANGELO NICHOLAS DEGUERRE

MEDICARE: ANGELO NICHOLAS DEGUERRE
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
1174H00000XHealth Educator

General Provider Information

NPI Number : 1902390644
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELO NICHOLAS DEGUERRE
Provider Business Mailing Address
First Line : 2470 WINDY HILL RD SE STE 300
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8621
Country : US
Telephone Number : 347-723-1076
Fax Number :
Provider Business Practice Location Address
First Line : 2470 WINDY HILL RD SE STE 300
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8621
Country : US
Telephone Number : 347-723-1076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2018
Last Update Date : 06/17/2018

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Directions to “ ANGELO NICHOLAS DEGUERRE ” Practice Location

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