Provider Demographics
NPI:1467642199
Name:SOELZ, GERALDINE G
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:G
Last Name:SOELZ
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 1:14527 RONNIE LN
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5158
Mailing Address - Country:US
Mailing Address - Phone:734-464-8906
Mailing Address - Fax:
Practice Address - Street 1:14527 RONNIE LN
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5158
Practice Address - Country:US
Practice Address - Phone:734-464-8906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0150980001Medicare PIN