Healthcare Provider Details

I. General information

NPI: 1891922894
Provider Name (Legal Business Name): MARK SEELEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WOODBINE LANE
DANVILLE PA
17822-8029
US

IV. Provider business mailing address

500 UNIVERSITY DRIVE MC CA 410
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6700
  • Fax: 570-214-6700
Mailing address:
  • Phone: 717-531-5638
  • Fax: 717-531-0983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301094371
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD452143
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberMT205542
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number343500
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: