Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD.207121 | LA |
N | 208200000X | Surgeon | 036124295 | IL |
N | 208600000X | Surgeon | 036124295 | IL |
NPI | 1831427806 |
---|---|
Provider Name | John Brentley Seal |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2009 |
Last Update Date | 24/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04835854 | (05) | MS |
2371495 | (05) | LA |