Provider Demographics
NPI:1700850914
Name:GEIB, ANN-JEANNETTE HELENE (MD)
Entity Type:Individual
Prefix:
First Name:ANN-JEANNETTE
Middle Name:HELENE
Last Name:GEIB
Suffix:
Gender:F
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01820207PT0002X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001907647OtherHIGHMARK BS
NJ0200093Medicaid
PA1016451290001Medicaid
PA106451290002Medicaid
PA188228OtherUNISON
PA50059796OtherCAPITAL BC
PA100185OtherGEISINGER
PA1554034OtherGATEWAY
PA106451290002Medicaid
PA101660RQJMedicare PIN
NJ157189UA1Medicare PIN