Provider Demographics
NPI:1235308941
Name:BICHIER, GERALDINE SUSAN SHAW (MD)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:SUSAN SHAW
Last Name:BICHIER
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:PO BOX 5876
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32627-5876
Mailing Address - Country:US
Mailing Address - Phone:352-378-2121
Mailing Address - Fax:
Practice Address - Street 1:4200 NW 90TH BLVD
Practice Address - Street 2:HAVEN HOSPICE
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606
Practice Address - Country:US
Practice Address - Phone:352-378-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82782207R00000X
CAME82782207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020221900Medicaid