Provider Demographics
NPI:1609816586
Name:GUISTWITE, DARRYL K (DO)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:K
Last Name:GUISTWITE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DARRYL
Other - Middle Name:K
Other - Last Name:GUISTWITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:56 ASHTON ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-6914
Mailing Address - Country:US
Mailing Address - Phone:717-609-2052
Mailing Address - Fax:717-258-1656
Practice Address - Street 1:56 ASHTON ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-6914
Practice Address - Country:US
Practice Address - Phone:717-609-2052
Practice Address - Fax:717-258-1656
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010715L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
050013Medicare ID - Type Unspecified
H45236Medicare UPIN