MEDICARE: ROBERT JEROME GELLER MD

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
1	208000000X	Pediatrics Physician	030771	GA
2	2080T0002X	Pediatric Medical Toxicology Physician	030771	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104823160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JEROME GELLER MD

Provider Business Mailing Address
First Line	:	49 JESSE HILL JR DR SE
Second Line	:	EMORY UNIV DEPT PEDIATRICS
City	:	ATLANTA
State	:	GA
Zip	:	30303-3049
Country	:	US
Telephone Number	:	404-616-6652
Fax Number	:	404-616-6657

Provider Business Practice Location Address
First Line	:	49 JESSE HILL JR DR SE
Second Line	:	EMORY UNIV DEPT PEDIATRICS
City	:	ATLANTA
State	:	GA
Zip	:	30303-3049
Country	:	US
Telephone Number	:	404-616-6652
Fax Number	:	404-616-6657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	09/11/2025

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