Provider Demographics
NPI:1295748101
Name:GUY, WILLIAM L (PHD, MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:GUY
Suffix:
Gender:M
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RIVERBANK DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4808
Mailing Address - Country:US
Mailing Address - Phone:313-319-8429
Mailing Address - Fax:
Practice Address - Street 1:22170 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-6007
Practice Address - Country:US
Practice Address - Phone:313-319-8429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010635512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2606324352OtherBLUE CROSS BLUE SHIELD MI
MI2608270052OtherBLUE CROSS/BLUE SHEILDMI
MIP00140666OtherRAILROAD MEDICARE
MI2608270052OtherBLUE CROSS/BLUE SHEILDMI
MIP00140666OtherRAILROAD MEDICARE