MEDICARE: MR. PATRICK JOHN GEML PA-C, MPAS

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1770555062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK JOHN GEML PA-C, MPAS

Provider Business Mailing Address
First Line	:	2375 BIRCH DR
Second Line	:
City	:	SAINT CLAIR
State	:	MI
Zip	:	48079-3707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 STONE ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-3563
Country	:	US
Telephone Number	:	801-982-9414
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	08/26/2013

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