1518160266 NPI number — DANIELLE B GUFFREY MD

Table of content: DANIELLE B GUFFREY MD (NPI 1518160266)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518160266 NPI number — DANIELLE B GUFFREY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUFFREY
Provider First Name:
DANIELLE
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1518160266
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 536
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43023-0536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-403-7949
Provider Business Mailing Address Fax Number:
614-846-3824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
153 VALLEY RUN PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POWELL
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43065-7822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-403-7949
Provider Business Practice Location Address Fax Number:
614-846-3824
Provider Enumeration Date:
06/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  35094727 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0050419 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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