Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | OH000206 | PA |
N | 222Z00000X | Podiatrist | OH000206 | PA |
Y | 224P00000X | Prosthetist | PO000144 | PA |
NPI | 1346774627 |
---|---|
Provider Name | Jonas Seeberg |
First Address | Abingdon, MD 21009-1204 |
Second Address | Abingdon, MD 21009-1204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2017 |
Last Update Date | 13/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011103100 | (05) | MD |