Provider Demographics
NPI:1679554646
Name:GEIER, GEORGE E (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:E
Last Name:GEIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 N WABASH AVE STE G-20
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2605
Mailing Address - Country:US
Mailing Address - Phone:765-660-7600
Mailing Address - Fax:765-651-7313
Practice Address - Street 1:330 N WABASH AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2600
Practice Address - Country:US
Practice Address - Phone:765-662-3921
Practice Address - Fax:765-662-8120
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01032066A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000001045087OtherANTHEM
IN100322190AMedicaid
IN100322190AMedicaid
IND95464Medicare UPIN