Healthcare Provider Details

I. General information

NPI: 1245060425
Provider Name (Legal Business Name): GEZA VERIK HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 08/03/2024
Certification Date: 08/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 CITATION RD
CARMEL IN
46032-1026
US

IV. Provider business mailing address

720 CITATION RD
CARMEL IN
46032-1026
US

V. Phone/Fax

Practice location:
  • Phone: 317-316-2998
  • Fax:
Mailing address:
  • Phone: 317-316-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number17001444A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: