Mark William Guelzow, MD
Family Medicine in Fayetteville, NY. Individual provider (NPI-1).
NPI number1124477484
StatusActive
Last updated in NPPESJul 3, 2021
Details
- NPI
- 1124477484
- Entity type
- Individual (NPI-1)
- Name
- Mark William Guelzow
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 8, 2016
- Certification date
- Jul 3, 2021
- Last updated
- Jul 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 301689 | NY | Yes |
Practice location
4101 Medical Center Dr Ste 1cFayetteville, NY 13066-6600
Phone 315-637-7878
Mailing address
8 Rowley DrNorthport, NY 11768-3244
Phone 561-523-3216
Other practice locations
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