Provider Demographics
NPI:1821024738
Name:ABELEDA, GUILLERMA (MD)
Entity Type:Individual
Prefix:
First Name:GUILLERMA
Middle Name:
Last Name:ABELEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GUILLERMA
Other - Middle Name:F
Other - Last Name:MILANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:45 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7918
Mailing Address - Country:US
Mailing Address - Phone:717-272-5577
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 422, SPORTSMAN ROAD
Practice Address - Street 2:BUILDING 37
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-0300
Practice Address - Country:US
Practice Address - Phone:610-678-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036939L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042648Medicare PIN
PAH25612Medicare UPIN