Healthcare Provider Details

I. General information

NPI: 1710010871
Provider Name (Legal Business Name): LINDA EDITH SEAVER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4223 E NISBET RD
PHOENIX AZ
85032-8119
US

IV. Provider business mailing address

4223 E NISBET RD
PHOENIX AZ
85032-8119
US

V. Phone/Fax

Practice location:
  • Phone: 623-670-0744
  • Fax: 602-404-0546
Mailing address:
  • Phone: 623-670-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17635
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number17635
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: