Healthcare Provider Details

I. General information

NPI: 1942432919
Provider Name (Legal Business Name): PATRICIA W SEO-MAYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA W SEO

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

PO BOX 418283
BOSTON MA
02241-8283
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8518
  • Fax:
Mailing address:
  • Phone: 703-558-1544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number0101248007
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD038931
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number48100
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: