Healthcare Provider Details

I. General information

NPI: 1285758532
Provider Name (Legal Business Name): RONALD A SEFF, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 FONTANA LN SUITE 108
BALTIMORE MD
21237-3047
US

IV. Provider business mailing address

19 FONTANA LN SUITE 108
BALTIMORE MD
21237-3047
US

V. Phone/Fax

Practice location:
  • Phone: 410-574-4040
  • Fax: 410-574-1255
Mailing address:
  • Phone: 410-574-4040
  • Fax: 410-574-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD16254
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberD16254
License Number StateMD

VIII. Authorized Official

Name: DR. RONALD ALAN SEFF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-574-4040