Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA08585900 | NJ |
NPI | 1063546067 |
---|---|
Provider Name | Dr. Jolene Susanne Seibel-Seamon |
First Address | Marlton, NJ 08053-3425 |
Second Address | Voorhees, NJ 08043-1548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0201014 | (05) | NJ |