Provider Demographics
NPI:1669472056
Name:BARTH, BEVERLY GEIST (PHD, MD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:GEIST
Last Name:BARTH
Suffix:
Gender:F
Credentials:PHD, MD
Other - Prefix:DR
Other - First Name:BEVERLY
Other - Middle Name:JEAN
Other - Last Name:GEIST-BARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 ERICA WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-2029
Mailing Address - Country:US
Mailing Address - Phone:407-327-5539
Mailing Address - Fax:
Practice Address - Street 1:MOZARTSTRRASSE 12
Practice Address - Street 2:
Practice Address - City:PASSAU
Practice Address - State:BAVARIA
Practice Address - Zip Code:94032
Practice Address - Country:DE
Practice Address - Phone:011498501-490-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054971207QG0300X
WI45361-020207QG0300X
FLME90049207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAI46960Medicare UPIN
GA08CBBDWMedicare ID - Type Unspecified