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General NPI Number Information
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NPI Number | 1700945128
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Entity Type | Individual
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Provider Name | SETH R EATON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 7350 VAN DUSEN RD STE 130
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City | LAUREL
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State | MD
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Zip | 20707-5267
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Country | US
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Telephone | 301-498-8880
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Fax | 301-498-7939
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Provider Business Mailing Address
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Address Line | 8771 SUSINI DR
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City | LAUREL
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State | MD
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Zip | 20723-1225
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Country | US
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Telephone | 301-317-1644
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0026556
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0026556
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License Number State | MD
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