Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 053069 | MI |
NPI | 1033284773 |
---|---|
Provider Name | Donald M. Seyfried |
First Address | Detroit, MI 48202 |
Second Address | Detroit, MI 48202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DS053069 | CHAMPUS-CHAMPUS (01) | |
DS053069 | COMMERCIAL-COMMERCIAL NUMBER (01) | |
F85543 | (02) |