Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301081112 | MI |
N | 111NI0900X | Internist | 4301081112 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301081112 | MI |
Y | 207RC0000X | Internist - Cardiovascular Disease | 63946 | MN |
NPI | 1023186566 |
---|---|
Provider Name | Mayra E. Guerrero |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 14/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H82776 | (02) |