Provider Demographics
NPI:1811321045
Name:GEISHAUSER, MICHAEL ROBERT (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:GEISHAUSER
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 HOWARD AVE STE F2
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4818
Mailing Address - Country:US
Mailing Address - Phone:814-889-2701
Mailing Address - Fax:814-889-7864
Practice Address - Street 1:501 HOWARD AVE STE F2
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4818
Practice Address - Country:US
Practice Address - Phone:814-889-2701
Practice Address - Fax:814-889-7864
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 174H00000X
DC31629791835P1200X
PARP447737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No174H00000XOther Service ProvidersHealth Educator
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy