Basic Information
| Provider Information | |||||||||
| NPI: | 1568403707 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERON | ||||||||
| FirstName: | MICHEAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 951603 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441930018 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 140 MORRIS RD | ||||||||
| Address2: | |||||||||
| City: | CIRCLEVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431131362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404748818 | ||||||||
| FaxNumber: | 7404776452 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 12/05/2007 | ||||||||
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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 | 207Q00000X | 35-03-8936-G | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.