Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 240119 | MA |
Y | 2080P0210X | Pediatric Nephrologist | 8408205-1205 | UT |
NPI | 1053357251 |
---|---|
Provider Name | Meredith L. Seamon |
First Address | Salt Lake City, UT 84141-3021 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 02/12/2021 |