Provider Demographics
NPI:1134129687
Name:GEDDE, MARGARET
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:
Last Name:GEDDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6266 AUTUMN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7205
Mailing Address - Country:US
Mailing Address - Phone:719-239-0643
Mailing Address - Fax:
Practice Address - Street 1:6266 AUTUMN LEAF DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-7205
Practice Address - Country:US
Practice Address - Phone:719-239-0643
Practice Address - Fax:877-237-8571
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42333207ZP0105X, 208D00000X
VA0101280234208D00000X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H78561Medicare UPIN
CO542778Medicare ID - Type Unspecified