Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 052918 | CT |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 275366 | NY |
NPI | 1093082869 |
---|---|
Provider Name | Dr. Michael William Geis |
First Address | Stamford, CT 06902-2548 |
Second Address | Stamford, CT 06905-5246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2011 |
Last Update Date | 01/09/2015 |