Provider Demographics
NPI:1255302527
Name:GEARY, ELISE WEINRICH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISE
Middle Name:WEINRICH
Last Name:GEARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:ELISE
Other - Last Name:WEINRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1955 22ND AVE
Mailing Address - Street 2:VERO BEACH DERMATOLOGY
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3083
Mailing Address - Country:US
Mailing Address - Phone:772-299-0085
Mailing Address - Fax:772-978-4193
Practice Address - Street 1:1955 22ND AVE
Practice Address - Street 2:VERO BEACH DERMATOLOGY
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3083
Practice Address - Country:US
Practice Address - Phone:772-299-0085
Practice Address - Fax:772-978-4193
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26404207N00000X
FL26404207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1042WOtherBCBS OF NORTH CAROLINA
NC54573OtherMEDCOST
NC02001260OtherUNITEDHEALTH CARE
NC8986324Medicaid
NCD33043Medicare UPIN
NC8986324Medicaid