Provider Demographics
NPI:1144512252
Name:GUFFREY, KATHRYN MARY (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARY
Last Name:GUFFREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3830
Mailing Address - Street 2:GRMC, CREDENTIALING
Mailing Address - City:HAGATNA
Mailing Address - State:GU
Mailing Address - Zip Code:96932-3830
Mailing Address - Country:US
Mailing Address - Phone:671-645-5546
Mailing Address - Fax:
Practice Address - Street 1:113 ROUTE 3
Practice Address - Street 2:GRMC, EMERGENCY DEPARTMENT
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96912
Practice Address - Country:US
Practice Address - Phone:671-645-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-08
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01513207P00000X
GUM-1990207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine