Healthcare Provider Details

I. General information

NPI: 1417198730
Provider Name (Legal Business Name): JAMES CLARK SEABERT M.D., PH.D., FAAFP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AN DEN QUELLEN 1
WIESBADEN HESSEN
65183
DE

IV. Provider business mailing address

AN DEN QUELLEN 1
WIESBADEN HESSEN
65183
DE

V. Phone/Fax

Practice location:
  • Phone: 0049611302832
  • Fax:
Mailing address:
  • Phone: 0049611302832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number070930
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: