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NPI Code Detail

MEDICARE: DR. DERIK JOSEF GEIST M.D.

MEDICARE: DR. DERIK JOSEF GEIST M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician27882WV

General Provider Information

NPI Number : 1104080563
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DERIK JOSEF GEIST M.D.
Provider Business Mailing Address
First Line : PO BOX 780
Second Line :
City : MORGANTOWN
State : WV
Zip : 26507-0780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6040 UNIVERSITY TOWN CENTRE DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-2421
Country : US
Telephone Number : 855-988-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2008
Last Update Date : 12/19/2025

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