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NPI Code Detail

MEDICARE: JOHN A SEBAS MD

MEDICARE: JOHN A SEBAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician36840MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275500233
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN A SEBAS MD
Provider Business Mailing Address
First Line : 1245 15TH ST N
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-1802
Country : US
Telephone Number : 320-253-5220
Fax Number : 320-203-2113
Provider Business Practice Location Address
First Line : 1555 NORTHWAY DR STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-1258
Country : US
Telephone Number : 320-251-1775
Fax Number : 320-240-3131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 08/28/2020

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