Mateo Guanzon, MD is a
Thoracic Surgery (cardiothoracic Vascular Surgery) physician based in Dyer, Indiana. Mateo Guanzon is licensed to practice in Indiana (license number 01035781A) and his current practice location is 2150 Gettler St Ste 400, Dyer, Indiana. He can be reached at his office (for appointments etc.) via phone at
(219) 865-0893.
NPI number for Mateo Guanzon is 1629073366 and his current mailing address is Po Box 781076, Detroit, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1629073366.
Physician's Profile
| Full Name | Mateo Guanzon |
|---|
| Gender | Male |
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| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
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| Location | 2150 Gettler St Ste 400, Dyer, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1629073366
- Provider Enumeration Date: 06/17/2005
- Last Update Date: 03/22/2021
Medical Identifiers
Medical identifiers for Mateo Guanzon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629073366 | NPI | - | NPPES |
| 100346800 | Medicaid | IN | |
| 300010982 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2086S0129X | Surgery - Vascular Surgery | 01035781A (Indiana) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 01035781 (Indiana) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 01035781A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mateo Guanzon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mateo Guanzon, MD
Po Box 781076,
Detroit, MI 48278-1076
Ph: (317) 528-4868 | Mateo Guanzon, MD
2150 Gettler St Ste 400,
Dyer, IN 46311-2385
Ph: (219) 865-0893 |
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