Provider Demographics
NPI:1497815211
Name:ARGUELLES, LUIS GOLEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:GOLEZ
Last Name:ARGUELLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 S MARINE CORPS DRIVE SUITE 126 GITC BUILDING
Mailing Address - Street 2:TRADE CENTER MEDICAL CLINIC
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:617-646-6354
Mailing Address - Fax:671-646-6362
Practice Address - Street 1:590 S MARINE CORPS DRIVE
Practice Address - Street 2:SUITE 126 GITC BUILDING
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:617-646-6354
Practice Address - Fax:671-646-6362
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM000141208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUL0456501Medicaid
GUD36271Medicare ID - Type Unspecified
GUL0456501Medicaid