Provider Demographics
NPI:1720019060
Name:GUERAMY, TIMOTHY C (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:GUERAMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2296
Mailing Address - Country:US
Mailing Address - Phone:706-417-2649
Mailing Address - Fax:970-642-4795
Practice Address - Street 1:104 W RUBY AVE
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2428
Practice Address - Country:US
Practice Address - Phone:970-641-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10960A207X00000X, 207XX0004X
CODR.0056307207X00000X, 207XX0004X
TXL9715207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184372402Medicaid
TX85263OtherSCOTT & WHITE
TX094771502Medicaid
TX8R0760OtherBCBS
TX7475736OtherAETNA TRS
TX8R0760OtherBCBS
TXH49087Medicare UPIN
TX184372402Medicaid
TXH49087Medicare UPIN