Provider Demographics
NPI:1881878296
Name:GUASTEFERRO, DANALYNN (DPM)
Entity type:Individual
Prefix:
First Name:DANALYNN
Middle Name:
Last Name:GUASTEFERRO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 WHITE WAY
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3125
Mailing Address - Country:US
Mailing Address - Phone:205-405-0567
Mailing Address - Fax:205-918-6699
Practice Address - Street 1:2660 10TH AVE S STE 608
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1627
Practice Address - Country:US
Practice Address - Phone:205-918-9181
Practice Address - Fax:205-918-6699
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL175213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK142OtherMEDICARE GROUP
ALU68472Medicare UPIN
AL000012577Medicare PIN
AL000012582Medicare PIN
AL000012390Medicare PIN