Provider Demographics
NPI:1841594520
Name:NESTOR M GUNO MD PC
Entity type:Organization
Organization Name:NESTOR M GUNO MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-348-6363
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-0507
Mailing Address - Country:US
Mailing Address - Phone:989-348-6363
Mailing Address - Fax:989-348-6111
Practice Address - Street 1:114 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-1741
Practice Address - Country:US
Practice Address - Phone:989-348-6363
Practice Address - Fax:989-348-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MING33010208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB46818Medicare UPIN