Healthcare Provider Details

I. General information

NPI: 1174563233
Provider Name (Legal Business Name): WILLIAM SEID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12255 FAIR LAKES PKWY KAISER PERMANENTE FAIR OAKS MEDICAL CENTER
FAIRFAX VA
22033-3952
US

IV. Provider business mailing address

2101 E JEFFERSON ST KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 703-934-5770
  • Fax:
Mailing address:
  • Phone: 301-816-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0101047062
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: