Basic Information
| Provider Information | |||||||||
| NPI: | 1316947617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOUNTVARNER | ||||||||
| FirstName: | GEOFFREY | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12710 WOODBRIDGE CT | ||||||||
| Address2: | |||||||||
| City: | MITCHELLVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207214243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028651121 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2041 GEORGIA AVE NW | ||||||||
| Address2: | EMERGENCY DEPT ADMIN OFFICE | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028651121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | D0054648 | MD | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.