Healthcare Provider Details

I. General information

NPI: 1134129687
Provider Name (Legal Business Name): DR. MARGARET GEDDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 06/30/2024
Certification Date: 06/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6266 AUTUMN LEAF DR
FREDERICKSBURG VA
22407-7205
US

IV. Provider business mailing address

6266 AUTUMN LEAF DR
FREDERICKSBURG VA
22407-7205
US

V. Phone/Fax

Practice location:
  • Phone: 719-239-0643
  • Fax: 877-237-8571
Mailing address:
  • Phone: 719-239-0643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number42333
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number42333
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101280234
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number0101280234
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: