Provider Demographics
NPI:1588627228
Name:GUIDI, ERIC JORDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JORDAN
Last Name:GUIDI
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 1:7811 MONTROSE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3353
Mailing Address - Country:US
Mailing Address - Phone:301-588-7888
Mailing Address - Fax:301-587-5002
Practice Address - Street 1:7811 MONTROSE RD STE 340
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3363
Practice Address - Country:US
Practice Address - Phone:301-588-7888
Practice Address - Fax:301-587-5002
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048078207X00000X
MDD52504207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC34310002OtherCAREFIRST BCBS
VA143533OtherANTHEM BCBS
VA200016574OtherMEDICARE RAILROAD RETRMNT
VA010148421Medicaid
VA548274OtherALLIANCE PPO
VAF60816FMedicare UPIN
045906N73Medicare ID - Type Unspecified