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General NPI Number Information
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NPI Number | 1396566923
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Entity Type | Organization
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Legal Business Name | SETON MEDICAL GROUP, INC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 3449 WILKENS AVE STE 300
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City | BALTIMORE
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State | MD
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Zip | 21229-5218
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Country | US
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Telephone | 410-644-2582
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Fax |
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Provider Business Mailing Address
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Address Line | 3449 WILKENS AVE STE 300
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City | BALTIMORE
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State | MD
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Zip | 21229-5218
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Country | US
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Telephone | 410-644-2582
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. WILLIAM B HIGGINBOTHAM
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Credential |
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Telephone | 667-234-3162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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