Healthcare Provider Details

I. General information

NPI: 1053371351
Provider Name (Legal Business Name): ANDREW JON SEILER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 W LIBERTY RD SUITE A
ANN ARBOR MI
48103-9746
US

IV. Provider business mailing address

3200 W LIBERTY RD SUITE A
ANN ARBOR MI
48103-9746
US

V. Phone/Fax

Practice location:
  • Phone: 734-994-5858
  • Fax:
Mailing address:
  • Phone: 734-994-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301069944
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: