Provider Demographics
NPI:1285631184
Name:GUZMAN-MORALES, CERES A (MD)
Entity Type:Individual
Prefix:MRS
First Name:CERES
Middle Name:A
Last Name:GUZMAN-MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CERES
Other - Middle Name:A
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:44199 DEQUINDRE RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1128
Mailing Address - Country:US
Mailing Address - Phone:248-879-5570
Mailing Address - Fax:248-879-2235
Practice Address - Street 1:44199 DEQUINDRE RD
Practice Address - Street 2:SUITE 222
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1128
Practice Address - Country:US
Practice Address - Phone:248-879-5570
Practice Address - Fax:248-879-2235
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035267208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics