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NPI Code Detail

MEDICARE: DR. GERALDINE OMEARA MD

MEDICARE: DR. GERALDINE OMEARA 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
1207P00000XEmergency Medicine Physician030174GA

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 : 1942204730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALDINE OMEARA MD
Provider Business Mailing Address
First Line : 1499 WALTON WAY
Second Line : STE 1400
City : AUGUSTA
State : GA
Zip : 30901-2602
Country : US
Telephone Number : 706-724-6100
Fax Number :
Provider Business Practice Location Address
First Line : 2260 WRIGHTSBORO RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30904-4764
Country : US
Telephone Number : 706-481-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 09/30/2013

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