1558588525 NPI number — DR. JOHANNES ADRIANUS GEERS MD

Table of content: DR. JOHANNES ADRIANUS GEERS MD (NPI 1558588525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558588525 NPI number — DR. JOHANNES ADRIANUS GEERS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEERS
Provider First Name:
JOHANNES
Provider Middle Name:
ADRIANUS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558588525
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BOX 1359
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COALDALE
Provider Business Mailing Address State Name:
ALBERTA
Provider Business Mailing Address Postal Code:
T1M1N3
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
403-345-5500
Provider Business Mailing Address Fax Number:
403-345-5507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BOX 1359
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COALDALE
Provider Business Practice Location Address State Name:
ALBERTA
Provider Business Practice Location Address Postal Code:
T1M1N3
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
403-345-5500
Provider Business Practice Location Address Fax Number:
403-345-5507
Provider Enumeration Date:
04/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME0072103 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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