Healthcare Provider Details

I. General information

NPI: 1811274699
Provider Name (Legal Business Name): CHRISTOPHER E. GEERTZ, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 12/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 TATE BLVD SE STE 105
HICKORY NC
28602-1384
US

IV. Provider business mailing address

6880 W SNOWVILLE RD #210
BRECKSVILLE OH
44141-3254
US

V. Phone/Fax

Practice location:
  • Phone: 850-319-6205
  • Fax:
Mailing address:
  • Phone: 800-579-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2010-01619
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number2010-01619
License Number StateNC

VIII. Authorized Official

Name: CHRISTOPHER E. GEERTZ
Title or Position: PRESIDENT
Credential: MD
Phone: 850-319-6205