Provider Demographics
NPI:1821014945
Name:GEREMIA, JOHN ANTHONY (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:GEREMIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6220 OLD DOBBIN LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5812
Mailing Address - Country:US
Mailing Address - Phone:410-742-6148
Mailing Address - Fax:612-367-0841
Practice Address - Street 1:2657 N SALISBURY BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2184
Practice Address - Country:US
Practice Address - Phone:410-742-6148
Practice Address - Fax:612-367-0841
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1439152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist