Provider Demographics
NPI:1144457565
Name:GEIB-ROSCH, BETHANY MARIA (MD)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MARIA
Last Name:GEIB-ROSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 VEAZEY DR
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-1668
Mailing Address - Country:US
Mailing Address - Phone:919-764-2237
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, CB#7160
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-1072
Practice Address - Fax:919-966-2220
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC157131390200000X
NC2013-01459283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program