MEDICARE: DR. DAVID W SEAMON 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
1	208000000X	Pediatrics Physician	0101044935	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	099029	OTHER	VA	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578552006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W SEAMON MD

Provider Business Mailing Address
First Line	:	15 CLEVELAND AVE
Second Line	:	SUITE 14
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2937
Country	:	US
Telephone Number	:	276-632-9714
Fax Number	:	276-632-0620

Provider Business Practice Location Address
First Line	:	15 CLEVELAND AVE
Second Line	:	SUITE 14
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-2937
Country	:	US
Telephone Number	:	276-632-9714
Fax Number	:	276-632-0620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	06/23/2012

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