Provider Demographics
NPI:1447757349
Name:GERINGER, RAGE LUKE UNDERWOOD (MD)
Entity type:Individual
Prefix:
First Name:RAGE
Middle Name:LUKE UNDERWOOD
Last Name:GERINGER
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 1:495 S GLENDO HWY
Mailing Address - Street 2:
Mailing Address - City:GLENDO
Mailing Address - State:WY
Mailing Address - Zip Code:82213-9616
Mailing Address - Country:US
Mailing Address - Phone:307-331-3375
Mailing Address - Fax:
Practice Address - Street 1:2301 HOUSE AVE STE 201
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3177
Practice Address - Country:US
Practice Address - Phone:307-638-7757
Practice Address - Fax:307-638-8359
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8669207R00000X
390200000X
WY16605A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program