Geronimo, Maria Socorro Ambulo

Geronimo, Maria Socorro Ambulo is an individual health care provider with primary practice located at 630 Matthews Township Pkwy , Matthews NC 28105-5322. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Geronimo, Maria Socorro Ambulo can be contacted via phone (704) 495-6020.

Contact Information

Primary practice address
630 Matthews Township Pkwy Matthews NC 28105-5322
Phone: (704) 495-6020
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 2012-00713 North Carolina
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 25MA07879400 New Jersey
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2012-00713 North Carolina

Profile Details

NPI number 1811097967
LBN Legal business name Geronimo, Maria Socorro Ambulo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jan 24th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811097967 NPPES
North Carolina MEDICAID 5920787
North Carolina MEDICAID 1811097967
North Carolina MEDICAID 0114821
North Carolina MEDICAID NC1594
North Carolina Other 25MA07879400

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