Provider Demographics
NPI:1487661831
Name:GELLER, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:GELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8186 LARK BROWN ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075
Mailing Address - Country:US
Mailing Address - Phone:410-730-3399
Mailing Address - Fax:410-740-4730
Practice Address - Street 1:8186 LARK BROWN ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075
Practice Address - Country:US
Practice Address - Phone:410-730-3399
Practice Address - Fax:410-740-4744
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034613207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
898L305EMedicare ID - Type Unspecified
D76216Medicare UPIN