Provider Demographics
NPI:1194860676
Name:SILAN, NOEL DEGUZMAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:DEGUZMAN
Last Name:SILAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11741
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931
Mailing Address - Country:US
Mailing Address - Phone:671-633-3668
Mailing Address - Fax:671-632-0027
Practice Address - Street 1:138 KAYEN CHANDO ST.
Practice Address - Street 2:EXPRESS MED PHARMACY BLDG
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929
Practice Address - Country:US
Practice Address - Phone:671-633-3668
Practice Address - Fax:671-632-0027
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPOD000004213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
52390Medicare UPIN