Healthcare Provider Details

I. General information

NPI: 1245200161
Provider Name (Legal Business Name): MICHAEL D SEEMULLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 HIGHWAY 81 NORTH
PIEDMONT SC
29673
US

IV. Provider business mailing address

6650 HIGHWAY 81 NORTH
PIEDMONT SC
29673
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-5910
  • Fax: 864-512-5915
Mailing address:
  • Phone: 864-512-5910
  • Fax: 864-512-5915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101-234556
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22632
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: