Provider Demographics
NPI:1699735506
Name:GUERRERO, SALVADOR RODRIGO (DO)
Entity type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:RODRIGO
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 BRAMPTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7404
Mailing Address - Country:US
Mailing Address - Phone:570-618-2300
Mailing Address - Fax:
Practice Address - Street 1:9201 CHERRY LANE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708
Practice Address - Country:US
Practice Address - Phone:301-497-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232022208600000X, 2086S0129X
FLOS136392086S0129X, 208600000X
MDH0084977207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4054H1OtherEMPIRE BC/BS
NY010213902OtherAMERICHOICE
NY02550223Medicaid
NY000000087982OtherGHI HMO
NY3C6532OtherHEALTHNET
NY9744672OtherGHI PPO
NY199040101OtherHEALTHPLUS
NY112922165GU01OtherCAREPLUS HEALTH PLAN
NY5519534OtherCHOICE CARE NETWORK
NY7512557OtherAETNA/USHC
NYP3300798OtherOXFORD HEALTH PLANS
NY11292216500OtherTOUCHTONE HEALTH
NY176165OtherELDERPLAN
NY23202201OtherNEIGHBORHOOD HEALTH
NY5519534OtherFIRST HEALTH NETWORK
NY5519534OtherFIRST HEALTH NETWORK
NY2779H1Medicare ID - Type Unspecified