Individual
RANDOLPH LEE GEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-6637
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-6637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
9400504
NC
2086S0102X
Surgical Critical Care Physician
9400504
NC
2086S0129X
Vascular Surgery Physician
Primary
9400504
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12524
PARTNERS
—
05
—
2004904000
—
WV
01
—
34990
BCBS
—
01
—
51716
MEDCOST
—
05
—
7302002
—
VA
01
—
7803811
AETNA
—
05
—
7934990
—
NC
05
—
Q0050I
—
SC
Enumeration date
12/13/2005
Last updated
11/12/2010
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