Provider Demographics
NPI:1851380059
Name:GEIBEL, GEORGE F (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:GEIBEL
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 1:200 GROTON ROAD
Mailing Address - Street 2:NASHOBA VALLEY HEALTHCARE GROUP
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432
Mailing Address - Country:US
Mailing Address - Phone:978-784-9000
Mailing Address - Fax:
Practice Address - Street 1:697 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462
Practice Address - Country:US
Practice Address - Phone:978-582-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASX1740OtherPTAN
MASX1727OtherPTAN 41
MA2071495Medicaid
MA2071495Medicaid
A55037Medicare UPIN