Provider Demographics
NPI:1467460709
Name:GOLEMBIEWSKI, GEOFFREY H (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:H
Last Name:GOLEMBIEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:385 HAWTHORNE LN
Mailing Address - Street 2:STE 200
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2100
Mailing Address - Country:US
Mailing Address - Phone:706-543-3130
Mailing Address - Fax:706-543-3215
Practice Address - Street 1:385 HAWTHORNE LN
Practice Address - Street 2:STE 200
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2100
Practice Address - Country:US
Practice Address - Phone:706-543-3130
Practice Address - Fax:706-543-3215
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA039351207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000661559DMedicaid
GA000661559CMedicaid
GA000661559CMedicaid
GAF96626Medicare UPIN
GA000661559DMedicaid