Provider Demographics
NPI:1003806241
Name:GEIGER, MARA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARA
Middle Name:L
Last Name:GEIGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SOUTH BLVD E
Mailing Address - Street 2:STE 290
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6122
Mailing Address - Country:US
Mailing Address - Phone:248-997-7900
Mailing Address - Fax:248-997-7918
Practice Address - Street 1:1701 SOUTH BLVD E
Practice Address - Street 2:STE 290
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6122
Practice Address - Country:US
Practice Address - Phone:248-997-7900
Practice Address - Fax:248-997-7918
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3488220Medicaid
MIC6559OtherMCARE
MI3488220Medicaid
MION37740002Medicare ID - Type Unspecified