Provider Demographics
NPI:1508842238
Name:GUERIN, MEGHAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:B
Last Name:GUERIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 W 121ST PL
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7921
Mailing Address - Country:US
Mailing Address - Phone:303-410-8041
Mailing Address - Fax:303-410-8044
Practice Address - Street 1:3830 W 121ST PL
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7921
Practice Address - Country:US
Practice Address - Phone:303-410-8041
Practice Address - Fax:303-410-8044
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37146208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01371467Medicaid
COG62095Medicare UPIN
COE50171Medicare ID - Type Unspecified