MEDICARE: DR. ANDREW WALTER GESKIE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3339	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	085V2	OTHER	NC	BCBS INDIVID. PROVIDER ID

General Provider Information

NPI Number	:	1902997505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW WALTER GESKIE D.C.

Provider Business Mailing Address
First Line	:	1770 N PARHAM RD
Second Line	:	SUITE 103
City	:	RICHMOND
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	252-321-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	1770 N PARHAM RD
Second Line	:	SUITE 103
City	:	RICHMOND
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	252-321-3579
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	08/28/2009

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