Provider Demographics
NPI:1174810295
Name:GIESE, GERMAN E (MD)
Entity type:Individual
Prefix:
First Name:GERMAN
Middle Name:E
Last Name:GIESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 NE 26TH ST
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1322
Mailing Address - Country:US
Mailing Address - Phone:954-565-7789
Mailing Address - Fax:
Practice Address - Street 1:1402 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1322
Practice Address - Country:US
Practice Address - Phone:954-565-7789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-10
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50877207R00000X
IL125059070207R00000X
FLME119253207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine