Active NPI
Guillermo Olguin Olivos, M.D
- Psychiatry Physician
- Wheaton, MD
National Provider Identifier
1417043167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DO9398
- Practice address
- 2424 Reedie Dr
Suite 300
Wheaton, MD 20902-4624 - Phone
- (240) 777-3209
- Fax
- (240) 777-3226
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | DO9398 | MD | Primary |
Addresses
Primary practice location
2424 Reedie Dr
Suite 300
Wheaton, MD 20902-4624
Mailing address
13 Hillside Rd
Unit F
Greenbelt, MD 20770-7792
Phone (301) 982-0834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO9398 | Other | MD | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO9398 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417043167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 HILLSIDE RD",
"address_2": "UNIT F",
"city": "GREENBELT",
"state": "MD",
"postal_code": "207707792",
"telephone_number": "301-982-0834",
"fax_number": "240-777-3226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 REEDIE DR",
"address_2": "SUITE 300",
"city": "WHEATON",
"state": "MD",
"postal_code": "209024624",
"telephone_number": "240-777-3209",
"fax_number": "240-777-3226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVOS",
"first_name": "GUILLERMO",
"middle_name": "OLGUIN",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "DO9398",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "DO9398",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.