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General NPI Number Information
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NPI Number | 1821095084
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Entity Type | Individual
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Provider Name | ELIZABETH MARYA SEYMOUR M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/03/2005
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 2529 BROAD AVE
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City | ALTOONA
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State | PA
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Zip | 16601-1912
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Country | US
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Telephone | 814-944-3569
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Fax | 814-944-8201
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Provider Business Mailing Address
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Address Line | 2529 BROAD AVE
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City | ALTOONA
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State | PA
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Zip | 16601-1912
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Country | US
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Telephone | 814-944-3569
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Fax | 814-944-8201
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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 | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | MD418861
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License Number State | PA
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