Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 12010973A | IN |
Y | 213EG0000X | General Practice | 12010973A | IN |
NPI | 1003017005 |
---|---|
Provider Name | Dr. Valerie Martinsen Seifert |
First Address | La Porte, IN 46350-3506 |
Second Address | La Porte, IN 46350-3506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 31/01/2018 |