Provider Demographics
NPI:1568942183
Name:RODRIGUEZ GUERRA, MIGUEL ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANTONIO
Last Name:RODRIGUEZ GUERRA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1448 10TH AVENUE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3579
Mailing Address - Country:US
Mailing Address - Phone:304-691-6381
Mailing Address - Fax:304-691-8591
Practice Address - Street 1:1249 15TH STREET
Practice Address - Street 2:SUITE 2000
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3662
Practice Address - Country:US
Practice Address - Phone:304-691-1000
Practice Address - Fax:304-691-1693
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2024-09-23
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Provider Licenses
StateLicense IDTaxonomies
WV33859207R00000X
NY312368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine