Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1424 | MN |
NPI | 1487754529 |
---|---|
Provider Name | Dr. James Peter Seim |
First Address | Corcoran, MN 55340-9459 |
Second Address | Corcoran, MN 55340-9459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T 39780 | (02) |