MEDICARE: ANTONY M GEORGE 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
1	2083S0010X	Sports Medicine (Preventive Medicine) Physician	35064060	OH
2	2083P0901X	Public Health & General Preventive Medicine Physician	35064060	OH

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	:	1366443541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONY M GEORGE M.D.

Provider Business Mailing Address
First Line	:	20575 CENTER RIDGE RD
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-3422
Country	:	US
Telephone Number	:	440-403-9506
Fax Number	:	440-403-9507

Provider Business Practice Location Address
First Line	:	20575 CENTER RIDGE RD
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-3422
Country	:	US
Telephone Number	:	440-403-9506
Fax Number	:	440-403-9507

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	12/14/2022

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Directions to “ ANTONY M GEORGE M.D.” Practice Location

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