Provider Demographics
NPI:1194807669
Name:GUARINO, CLINTON TOMS (MD)
Entity type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:TOMS
Last Name:GUARINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3630 8TH STREET PL NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-8086
Mailing Address - Country:US
Mailing Address - Phone:828-304-9916
Mailing Address - Fax:828-322-5485
Practice Address - Street 1:1321 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2535
Practice Address - Country:US
Practice Address - Phone:828-322-3898
Practice Address - Fax:828-322-5485
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89118EMedicaid
2344801Medicare ID - Type Unspecified
NC89118EMedicaid