Healthcare Provider Details

I. General information

NPI: 1114504727
Provider Name (Legal Business Name): AMARIS NICOLE GEISLER BS, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 BUFORD DR STE 100
BUFORD GA
30519-8142
US

IV. Provider business mailing address

2828 BUFORD DR STE 100
BUFORD GA
30519-8142
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-5484
  • Fax:
Mailing address:
  • Phone: 404-355-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number103792
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: