Individual
DR. GEOFFREY EDWARD MICKELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
01075563A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
036130375
IL
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
074800
GA
Other
Enumeration date
04/13/2009
Last updated
04/24/2018
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