Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 03456 | KY |
N | 208000000X | Pediatrician | LL1690 | SC |
Y | 2080P0204X | Pediatric Emergency Doctor | 03456 | KY |
NPI | 1063654119 |
---|---|
Provider Name | Dr. Rebecca Lauren Starr Seal |
First Address | Chicago, IL 60677-6879 |
Second Address | Louisville, KY 40202-1821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 16/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201065720 | (05) | IN |
7100133180 | (05) | KY |