Most Relevant Information
Provider Data
| NPI Number: | 1003278862 |
| Provider Name: | MICHAEL DAMASO DE GUZMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/22/2016 |
| Last Updated: | 12/07/2021 |
Provider Practice Location
171 ASHLEY AVE
CHARLESTON
SC
294254423
Practice Location Phone/Fax
| Phone: | 8437921414 |
| Fax: |
Provider Mailing Location
PO BOX 751461
CHARLOTTE
NC
282751461
Provider Mailing Phone/Fax
| Phone: | 8437926200 |
| Fax: |