Healthcare Provider Details

I. General information

NPI: 1104823160
Provider Name (Legal Business Name): ROBERT JEROME GELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 JESSE HILL JR DR SE EMORY UNIV DEPT PEDIATRICS
ATLANTA GA
30303-3049
US

IV. Provider business mailing address

49 JESSE HILL JR DR SE EMORY UNIV DEPT PEDIATRICS
ATLANTA GA
30303-3049
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-6652
  • Fax: 404-616-6657
Mailing address:
  • Phone: 404-616-6652
  • Fax: 404-616-6657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number030771
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2080T0002X
TaxonomyPediatric Medical Toxicology Physician
License Number030771
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: