Provider Demographics
NPI:1396199543
Name:GUO, ROSE (DO)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LEES LN
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3132
Mailing Address - Country:US
Mailing Address - Phone:704-807-0939
Mailing Address - Fax:
Practice Address - Street 1:301 E WENDOVER AVE STE 311
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1210
Practice Address - Country:US
Practice Address - Phone:336-276-6161
Practice Address - Fax:336-230-2150
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-00492207SG0201X
PAOT017330207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)