Provider Demographics
NPI:1639286784
Name:GEARY, CANDICE (MD)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:GEARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 KINGSBOROUGH SQ
Mailing Address - Street 2:STE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5054
Mailing Address - Country:US
Mailing Address - Phone:757-547-2322
Mailing Address - Fax:757-547-9439
Practice Address - Street 1:612 KINGSBOROUGH SQ
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5041
Practice Address - Country:US
Practice Address - Phone:757-436-0167
Practice Address - Fax:757-436-0236
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101057750207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA160001617Medicare PIN