Provider Demographics
NPI:1841466422
Name:DE GUZMAN, JOY IMPERIAL (MD)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:IMPERIAL
Last Name:DE GUZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751848
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1848
Mailing Address - Country:US
Mailing Address - Phone:828-274-6190
Mailing Address - Fax:828-277-4890
Practice Address - Street 1:68 SWEETEN CREEK RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2318
Practice Address - Country:US
Practice Address - Phone:828-277-4800
Practice Address - Fax:828-277-4890
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247894208100000X
NC2010-00975208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2076701Medicare PIN