Provider Demographics
NPI:1891188959
Name:GUIDO, ANTHONY JOSEPH (HIS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:GUIDO
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30128 HARPER AVE
Mailing Address - Street 2:SUITE 1(A)
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-1662
Mailing Address - Country:US
Mailing Address - Phone:586-200-3025
Mailing Address - Fax:586-200-3027
Practice Address - Street 1:30128 HARPER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-1662
Practice Address - Country:US
Practice Address - Phone:586-200-3025
Practice Address - Fax:586-200-3027
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501004935237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist