Healthcare Provider Details

I. General information

NPI: 1528141017
Provider Name (Legal Business Name): GEOFFREY GARLAND GRAMMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 OLNEY LAYTONSVILLE RD STE 212
OLNEY MD
20832-3701
US

IV. Provider business mailing address

3416 OLANDWOOD CT
OLNEY MD
20832-1372
US

V. Phone/Fax

Practice location:
  • Phone: 301-982-3437
  • Fax:
Mailing address:
  • Phone: 301-969-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberD0080837
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101056625
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101056625
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0080837
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: