Individual
DR. MICHAEL J. GEORGETSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
174652-1
NY
207RG0100X
Gastroenterology Physician
Primary
MD036907E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010736000002
—
PA
01
—
100014270
RR MEDICARE PIN
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039897
MEDICARE GROUP
PA
01
—
P00379066
RR MEDICARE PIN
NY
Enumeration date
02/27/2006
Last updated
03/05/2021
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