Provider Demographics
NPI:1336156405
Name:GEIER, CARL DAVID JR (MD)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:DAVID
Last Name:GEIER
Suffix:JR
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 1:851 LEONARD FULGHUM BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3787
Mailing Address - Country:US
Mailing Address - Phone:843-971-7672
Mailing Address - Fax:843-971-9351
Practice Address - Street 1:851 LEONARD FULGHUM BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3787
Practice Address - Country:US
Practice Address - Phone:843-971-7672
Practice Address - Fax:843-971-9351
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28159207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC281590Medicaid
SCAA1019Medicare ID - Type Unspecified
SC281590Medicaid