Provider Demographics
NPI:1831105956
Name:GUIGELAAR, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:GUIGELAAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 S WENONA ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-8820
Mailing Address - Country:US
Mailing Address - Phone:989-893-9705
Mailing Address - Fax:989-893-8206
Practice Address - Street 1:200 S WENONA ST
Practice Address - Street 2:SUITE 225
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-8820
Practice Address - Country:US
Practice Address - Phone:989-893-9705
Practice Address - Fax:989-893-8206
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIJG042006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1100910252OtherBCBS OF MI
MI4159093Medicaid
MI1100910252OtherHEALTH PLUS
MI1100910252OtherBCBS OF MI
MIB46965Medicare UPIN