Healthcare Provider Details

I. General information

NPI: 1609089549
Provider Name (Legal Business Name): RICHARD C GEARY JR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 MARKET ST SUITE 1
WHEELING WV
26003-2912
US

IV. Provider business mailing address

1038 MARKET ST SUITE 1
WHEELING WV
26003-2912
US

V. Phone/Fax

Practice location:
  • Phone: 304-232-4266
  • Fax: 304-233-0132
Mailing address:
  • Phone: 304-232-4266
  • Fax: 304-233-0132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD C GEARY JR.
Title or Position: OWNER
Credential: D.O.
Phone: 304-232-4266