Provider Demographics
NPI:1053527515
Name:LEON-GUERRERO, ARCHANA GOEL (MD)
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:GOEL
Last Name:LEON-GUERRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 ELLICOTT CENTER DR
Mailing Address - Street 2:UNIT 2714
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21041-7501
Mailing Address - Country:US
Mailing Address - Phone:410-750-3668
Mailing Address - Fax:410-750-3668
Practice Address - Street 1:3375 ELLICOTT CENTER DR
Practice Address - Street 2:UNIT 2714
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21041-7501
Practice Address - Country:US
Practice Address - Phone:410-750-3668
Practice Address - Fax:410-750-3668
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00659242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry