1124386263 NPI number — GUERSON MANAGEMENT

Table of content: (NPI 1124386263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124386263 NPI number — GUERSON MANAGEMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUERSON MANAGEMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124386263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1693 CARATOKE HIGHWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOYOCK
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-435-1665
Provider Business Mailing Address Fax Number:
252-435-2111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
237 HANBURY ROAD
Provider Second Line Business Practice Location Address:
SUITE 17-198
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-435-1665
Provider Business Practice Location Address Fax Number:
252-435-2111
Provider Enumeration Date:
04/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
NORAH
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
252-435-1665

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  1-06-2991 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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