Provider Demographics
NPI:1659685261
Name:GUIDER, DOUGLAS CLAYTON (RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:CLAYTON
Last Name:GUIDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-4321
Mailing Address - Country:US
Mailing Address - Phone:252-637-5259
Mailing Address - Fax:252-637-5259
Practice Address - Street 1:2001 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-3454
Practice Address - Country:US
Practice Address - Phone:252-672-8365
Practice Address - Fax:252-672-8368
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist