Healthcare Provider Details

I. General information

NPI: 1346284106
Provider Name (Legal Business Name): ROBERT D SEELIG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 N BALLAS RD DEPT RADIOLOGY
SAINT LOUIS MO
63131-2329
US

IV. Provider business mailing address

660 S EUCLID AVE CB 8131
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-5170
  • Fax: 314-996-4261
Mailing address:
  • Phone: 314-362-7200
  • Fax: 314-747-4189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR3H11
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: