Basic Information
Provider Information
NPI: 1679512545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEIST
FirstName: ROBERT
MiddleName: MILLER
NamePrefix: DR.
NameSuffix: IV
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 187 MEDICAL PARK DR
Address2:  
City: BREVARD
State: NC
PostalCode: 287124189
CountryCode: US
TelephoneNumber: 8288849362
FaxNumber: 8288843851
Practice Location
Address1: 187 MEDICAL PARK DR
Address2:  
City: BREVARD
State: NC
PostalCode: 287124189
CountryCode: US
TelephoneNumber: 8288849362
FaxNumber: 8288843851
Other Information
ProviderEnumerationDate: 06/06/2006
LastUpdateDate: 07/14/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207Q00000X2007-00854NCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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