Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DS038276 | PA |
NPI | 1083999759 |
---|---|
Provider Name | Merriam Seyedain |
First Address | Philadelphia, PA 19140-5007 |
Second Address | Philadelphia, PA 19140-5007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2011 |
Last Update Date | 13/10/2011 |