Provider Demographics
NPI:1407087711
Name:GUIRGUIS, GEORGE (DO, FACOG)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:GUIRGUIS
Suffix:
Gender:M
Credentials:DO, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4390
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46082-4390
Mailing Address - Country:US
Mailing Address - Phone:305-906-1797
Mailing Address - Fax:201-608-0497
Practice Address - Street 1:174 LILY POND AVE FL 2
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4608
Practice Address - Country:US
Practice Address - Phone:833-732-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021542207VM0101X
NJ25MB09439000207VM0101X
FL17884207VM0101X
IN02006092B207VM0101X
NY284409207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1629577804OtherPRACTICE NPI
1407087711OtherTYPE I PERSONAL NPI
PA1508453010OtherPENN HIGHLANDS NPI
1649219015OtherPRACTICE NPI
1629577804OtherPRACTICE NPI