Provider Demographics
NPI:1538233192
Name:GUERRA, MARIA MERCEDES (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MERCEDES
Last Name:GUERRA
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 1:13200 STRICKLAND RD # R
Mailing Address - Street 2:SUITE 120
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5212
Mailing Address - Country:US
Mailing Address - Phone:919-720-4876
Mailing Address - Fax:855-861-0602
Practice Address - Street 1:13200 STRICKLAND RD # R
Practice Address - Street 2:SUITE 120
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5212
Practice Address - Country:US
Practice Address - Phone:919-720-4876
Practice Address - Fax:855-861-0602
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046190208000000X
NC2013-01597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2013-01597OtherNORTH CAROLINA MEDICAL BOARD
CT046190OtherSTATE LICENSE
NC2013-01597OtherNORTH CAROLINA MEDICAL BOARD