Provider Demographics
NPI:1366563199
Name:GUARINO, WALTER CESAR (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:CESAR
Last Name:GUARINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MISS
Other - First Name:ELINA
Other - Middle Name:AMESPIL
Other - Last Name:GUARINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:501 CHURCH ST NE STE 206
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4734
Mailing Address - Country:US
Mailing Address - Phone:703-887-6423
Mailing Address - Fax:
Practice Address - Street 1:501 CHURCH ST NE STE 206
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4734
Practice Address - Country:US
Practice Address - Phone:703-887-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010279702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA174571Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER