MEDICARE: MARK J SEIFERT 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	207RC0000X	Cardiovascular Disease Physician	33429	AZ
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	33429	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00162117	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WCSKQ	OTHER	AZ	SUN HEALTH GROUP #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942201694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK J SEIFERT MD

Provider Business Mailing Address
First Line	:	2500 W UTOPIA RD
Second Line	:	STE. 100
City	:	PHOENIX
State	:	AZ
Zip	:	85027-4171
Country	:	US
Telephone Number	:	623-434-6200
Fax Number	:	623-434-6164

Provider Business Practice Location Address
First Line	:	9250 N 3RD STREET
Second Line	:	SUITE 3010
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2425
Country	:	US
Telephone Number	:	602-861-1168
Fax Number	:	602-861-1763

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	09/13/2013

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Directions to “ MARK J SEIFERT MD” Practice Location

Language	Start Address	Practice Location

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