Provider Demographics
NPI:1740391432
Name:GUERIN, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:GUERIN
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 1:90 TER HEUN DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2533
Mailing Address - Country:US
Mailing Address - Phone:508-540-0604
Mailing Address - Fax:508-457-0129
Practice Address - Street 1:90 TER HEUN DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2533
Practice Address - Country:US
Practice Address - Phone:508-540-0604
Practice Address - Fax:508-457-0129
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79325207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0023510OtherNEIGHBORHOOD HEALTH PLAN
MA2275959OtherAETNA
MA754160OtherTUFTS
MAB20485702OtherCIGNA
MA1740391432OtherUNICARE
MA000000029667OtherBOSTON MEDICAL CENTER
MA060058511OtherMEDICARE ID
11545132OtherCAQH
MA1740391432OtherNETWORK HEALTH
MA3942OtherHARVARD PILGRIM
MAJ14511OtherBLUE CROSS BLUE SHIELD
MA060058511OtherTRICARE
MA1740391432OtherGREAT WEST HEALTHCARE
MA25-00648OtherUNITED HEALTHCARE
MA3123324Medicaid
MA1740391432OtherGREAT WEST HEALTHCARE
MA754160OtherTUFTS