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General NPI Number Information
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NPI Number | 1912401001
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Entity Type | Organization
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Legal Business Name | PAOLA M SEIDEL M D PLLC
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 2615 W 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-1627
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Country | US
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Telephone | 248-850-7068
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Fax | 248-850-7112
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Provider Business Mailing Address
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Address Line | 2615 W 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-1627
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Country | US
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Telephone | 248-850-7068
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Fax | 248-850-7112
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Authorized Official
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Title or Position | PROVIDER
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Name | PAOLA M SEIDEL
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Credential | MD
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Telephone | 248-850-7068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301058096
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License Number State | MI
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