Healthcare Provider Details

I. General information

NPI: 1194633297
Provider Name (Legal Business Name): ROLAND SEWARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8802 HUNTING LN APT 102
LAUREL MD
20708-1254
US

IV. Provider business mailing address

8802 HUNTING LN APT 102
LAUREL MD
20708-1254
US

V. Phone/Fax

Practice location:
  • Phone: 757-412-9880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM05945
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: