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General NPI Number Information
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NPI Number | 1760477756
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Entity Type | Individual
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Provider Name | JOHN WADE SEEDOR MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 204 E CHESTER PK SUITE 4
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City | RIDLEY PARK
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State | PA
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Zip | 19078-1709
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Country | US
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Telephone | 610-521-4677
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Fax | 610-521-0951
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Provider Business Mailing Address
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Address Line | 204 E CHESTER PK SUITE 4
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City | RIDLEY PARK
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State | PA
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Zip | 19078-1709
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Country | US
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Telephone | 610-521-4677
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Fax | 610-521-0951
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MD027831E
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License Number State | PA
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