Provider Demographics
NPI:1306860390
Name:MANN, GEOFFREY S (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:S
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5930 HAMILTON BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESCOSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9654
Mailing Address - Country:US
Mailing Address - Phone:610-398-8141
Mailing Address - Fax:610-366-7241
Practice Address - Street 1:911 E BRADY ST
Practice Address - Street 2:EMERGENCY MEDICINE
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4646
Practice Address - Country:US
Practice Address - Phone:724-284-4550
Practice Address - Fax:724-281-4032
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD419751207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019479220001Medicaid
PA0000009748OtherHIGHMARK
PA0000009748OtherHIGHMARK