Individual
DR. GEOFFRY DE GENNARO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301105483
MI
2085R0202X
Diagnostic Radiology Physician
Primary
M-15099
ID
Other
Enumeration date
06/24/2014
Last updated
07/23/2020
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