Provider Demographics
NPI:1144321555
Name:KENNETH R. GUISTWITE, M.D. A P.C.
Entity type:Organization
Organization Name:KENNETH R. GUISTWITE, M.D. A P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUISTWITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-243-1516
Mailing Address - Street 1:522 S PITT ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3820
Mailing Address - Country:US
Mailing Address - Phone:717-243-1516
Mailing Address - Fax:717-243-4849
Practice Address - Street 1:522 S PITT ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3820
Practice Address - Country:US
Practice Address - Phone:717-243-1516
Practice Address - Fax:717-243-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010715L207Q00000X
PAMD014273E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050013Medicare ID - Type Unspecified