Provider Demographics
NPI:1295824787
Name:GUERRIERO, MICHAEL SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:GUERRIERO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E JOHN ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4938
Mailing Address - Country:US
Mailing Address - Phone:704-849-8171
Mailing Address - Fax:704-849-8078
Practice Address - Street 1:300 E JOHN ST
Practice Address - Street 2:SUITE 130
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4938
Practice Address - Country:US
Practice Address - Phone:704-849-8171
Practice Address - Fax:704-849-8078
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085MHOtherBCBS
NC89085MHMedicaid
NC623832OtherACN PIN NO.
NC7248444OtherAETNA PIN NO.
NC9363857OtherPHCS PIN NO.
NC78119Medicare UPIN
NC085MHOtherBCBS