Basic Information
Provider Information
NPI: 1396851093
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUZOWSKI
FirstName: MICHELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 MAIN ST
Address2:  
City: LEWISTON
State: ME
PostalCode: 042407027
CountryCode: US
TelephoneNumber: 2077950111
FaxNumber: 2077952766
Practice Location
Address1: 76 HIGH ST
Address2: STE 300
City: LEWISTON
State: ME
PostalCode: 042407649
CountryCode: US
TelephoneNumber: 2077955544
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/22/2006
LastUpdateDate: 02/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X016566MEY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200XMD16566MEN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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