Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 37632 | MN |
NPI | 1184662967 |
---|---|
Provider Name | Marco A Guerrero |
First Address | Minneapolis, MN 55425-4516 |
Second Address | St. Paul, MN 55101-2502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 06/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
812900200 | (05) | MN |
H33926 | (02) |