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NPI Code Detail

MEDICARE: DR. MARY E GEOROFF MD

MEDICARE: DR. MARY E GEOROFF 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician200501224NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528046562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY E GEOROFF MD
Provider Business Mailing Address
First Line : 1256 THAYER DR
Second Line :
City : ASHEBORO
State : NC
Zip : 27205-4143
Country : US
Telephone Number : 336-387-2500
Fax Number : 336-387-2568
Provider Business Practice Location Address
First Line : 706 GREEN VALLEY RD
Second Line : SUITE 104
City : GREENSBORO
State : NC
Zip : 27408-7038
Country : US
Telephone Number : 336-387-2500
Fax Number : 336-387-2568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 01/12/2016

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