Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 407013 | MI |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME126537 | FL |
NPI | 1205902673 |
---|---|
Provider Name | Michael D. Seidman |
First Address | Celebration, FL 34747-5436 |
Second Address | Celebration, FL 34747-5436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 09/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
284774310 | (05) | MI |
700H262260 | BLUE CROSS-BLUE CROSS (01) | |
E86671 | (02) | |
MS407013 | CHAMPUS-CHAMPUS (01) | |
MS407013 | COMMERCIAL-COMMERCIAL NUMBER (01) |