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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

MARK C GUERDAN, DO
6525 PROFESSIONAL PL
SUITE B
RIVERDALE, GA30274-2519
 Phone: 404-254-5496
 Fax: 404-254-5829
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Pain Medicine

208VP0000X
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for MARK C GUERDAN · (Male)

NPI Number 1326089574
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/09/2006
Last updated 07/14/2014 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
GA License # 061081
GA License # 61081
KY License # 31403
NY License # 62257
GA Medicaid 003135345A
GA Medicaid 003135346A
GA Medicare PIN 202I052868
Hospital affiliation(s)
  • MEDICAL CENTER OF CENTRAL GEORGIA - (Acute Care)
    777 HEMLOCK STREET
    MACON, GA 31201
  • NORTHSIDE HOSPITAL - (Acute Care)
    1000 JOHNSON FERRY ROAD, NE
    ATLANTA, GA 30342
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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