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Individual

DR. DEANNE N GEURKINK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11134 BROAD RIVER RD, SUITE D, IRMO, SC 29063-7616
(803) 732-0920
(803) 732-0920
Mailing address
11134 BROAD RIVER RD, SUITE D, IRMO, SC 29063-7616
(803) 732-0920
(803) 732-0920

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
19500
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
195005
SC
05
GP5337
SC
Enumeration date
08/10/2006
Last updated
06/22/2012
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