Provider Demographics
NPI:1356329551
Name:EARLE, GUY H (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:H
Last Name:EARLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9226 BAYSHORE DR NW
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9196
Mailing Address - Country:US
Mailing Address - Phone:360-692-6202
Mailing Address - Fax:360-698-5808
Practice Address - Street 1:9226 BAYSHORE DR NW
Practice Address - Street 2:SUITE 230
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9196
Practice Address - Country:US
Practice Address - Phone:360-692-6202
Practice Address - Fax:360-698-5808
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2010-10-25
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Provider Licenses
StateLicense IDTaxonomies
WI48805207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F09673Medicare UPIN