Provider Demographics
NPI:1306921648
Name:GUAY, MARIE A (DO)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:A
Last Name:GUAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 COTTAGE ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-1817
Mailing Address - Country:US
Mailing Address - Phone:207-324-5477
Mailing Address - Fax:207-324-5466
Practice Address - Street 1:312 COTTAGE ST STE B
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-1817
Practice Address - Country:US
Practice Address - Phone:207-324-5477
Practice Address - Fax:207-324-5466
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO13432084P0800X
ME13432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM4702Medicare ID - Type Unspecified
E68820Medicare UPIN