Provider Demographics
NPI:1295826006
Name:MCGEATH, DENNIS EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EDWARD
Last Name:MCGEATH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:345 N DIVISION RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-9416
Mailing Address - Country:US
Mailing Address - Phone:231-347-8382
Mailing Address - Fax:231-347-6628
Practice Address - Street 1:345 N DIVISION RD
Practice Address - Street 2:SUITE D
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9416
Practice Address - Country:US
Practice Address - Phone:231-347-8382
Practice Address - Fax:231-347-6628
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010413372080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1998799Medicaid
MIB48996Medicare UPIN