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General NPI Number Information
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NPI Number | 1861673121
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Entity Type | Individual
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Provider Name | ROBERT B. GELLER MD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 225 MEMORIAL DR SUITE 1600
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 920-361-6360
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Fax | 920-361-5324
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Provider Business Mailing Address
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Address Line | 225 MEMORIAL DR SUITE 1600
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 920-361-6360
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Fax | 920-361-5324
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 43939
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License Number State | WI
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