=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285670711
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAMONA G. SEIDEL, M.D., LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 530 COLLEGE PKWY
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21409-4614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-349-2250
-----------------------------------------------------
Fax | 410-349-2256
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 530 COLLEGE PKWY
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21409-4614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-349-2250
-----------------------------------------------------
Fax | 410-349-2256
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | DR. RAMONA G SEIDEL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 410-349-2250
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | D0052944
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------