Provider Demographics
NPI:1528065471
Name:GEISE, ROBERT EDWARD (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDWARD
Last Name:GEISE
Suffix:
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 1:1100 9TH AVE
Mailing Address - Street 2:MS:H7-ID
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-341-0846
Mailing Address - Fax:206-223-6814
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:MS:H7-ID
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-341-0846
Practice Address - Fax:206-223-6814
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79275207RI0200X
WAMD37221207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8248445Medicaid
WAGAB25289Medicare PIN
WAGAB13562Medicare PIN
WAGAB13564Medicare PIN
WAGAB13565Medicare PIN
WA8865364Medicare PIN
WAAB25289Medicare PIN
WAGAB13563Medicare PIN
WAGAB13566Medicare PIN
WA8248445Medicaid
WAG8878691Medicare PIN