Healthcare Provider Details
I. General information
NPI: 1376407700
Provider Name (Legal Business Name): SEAMUS R MCCANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 S SNODGRASS DR
PALMER AK
99645-9750
US
IV. Provider business mailing address
PO BOX 876741
WASILLA AK
99687-6741
US
V. Phone/Fax
- Phone: 907-373-4732
- Fax:
- Phone: 907-677-6467
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: