Provider Demographics
NPI:1992964316
Name:GUY, KEYTESHIA (MD)
Entity type:Individual
Prefix:DR
First Name:KEYTESHIA
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10403 HOSPITAL DR STE G4
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3137
Mailing Address - Country:US
Mailing Address - Phone:301-856-3019
Mailing Address - Fax:301-856-9370
Practice Address - Street 1:10403 HOSPITAL DR STE 103
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3149
Practice Address - Country:US
Practice Address - Phone:301-856-8990
Practice Address - Fax:301-856-8994
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0069138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1801837786OtherGROUP NPI - CLINTON FAMILY MEDICAL CENTER
MD1851473722OtherGROUP NPI - MEDICAL AND SURGICAL CLINICS OF SOUTHERN MARYLAND