Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | MD430581 | PA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD430581 | PA |
NPI | 1114960432 |
---|---|
Provider Name | Dr. Peter H. Seidenberg |
First Address | Hershey, PA 17033-0858 |
Second Address | State College, PA 16803-6705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 15/10/2018 |