Individual
DR. MARIA SOCORRO AMBULO GERONIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
630 MATTHEWS TOWNSHIP PKWY, MATTHEWS, NC 28105-5322
(704) 495-6334
Mailing address
5960 FAIRVIEW RD STE 500, CHARLOTTE, NC 28210-3113
(704) 495-6334
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012-00713
NC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
2012-00713
NC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
25MA07879400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114821
—
NJ
05
—
1811097967
—
NC
01
—
25MA07879400
STATE LICENSE
NJ
05
—
5920787
—
NC
05
—
NC1594
—
SC
Enumeration date
09/25/2006
Last updated
05/11/2026
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