Provider Demographics
NPI:1215028436
Name:GUADALUPE, HAROLD W (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:W
Last Name:GUADALUPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2950 ROBERTSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1268
Mailing Address - Country:US
Mailing Address - Phone:513-281-4400
Mailing Address - Fax:513-587-8213
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:513-281-4400
Practice Address - Fax:513-281-4545
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-077755207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2269094Medicaid
OHGU4014154Medicare ID - Type Unspecified
OHH50041Medicare UPIN