MEDICARE: MR. ROBERT K SEIDEL 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	208D00000X	General Practice Physician	35-03-8098-S	OH
2	207R00000X	Internal Medicine Physician	35-038098	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00063352	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000313737	OTHER	OH	ANTHEM
3	03052975300	OTHER	OH	OHIO BUREAU OF W.C.
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831178516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT K SEIDEL MD

Provider Business Mailing Address
First Line	:	24701 EUCLID AVE
Second Line	:	THIRD FLOOR - BILLING SERVICES
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:	330-665-4430
Fax Number	:	330-666-9012

Provider Business Practice Location Address
First Line	:	3624 W MARKET ST STE 103
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-4510
Country	:	US
Telephone Number	:	330-665-4430
Fax Number	:	330-666-9012

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	04/20/2012

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Directions to “ MR. ROBERT K SEIDEL MD” Practice Location

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