Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | MD424459 | PA |
Y | 2086S0127X | Trauma Surgeon | MD424459 | PA |
NPI | 1184780546 |
---|---|
Provider Name | Mark J Seamon |
First Address | Philadelphia, PA 19104-2640 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 06/11/2019 |