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NPI Code Detail

MEDICARE: DR. GEOFFREY K SEIDEL MD

MEDICARE:  DR. GEOFFREY K SEIDEL  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician4391954762MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5250011835OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2107664OTHERMICARE CHOICES-PREFERRED
3GS054872OTHERMIBCBSM
4C6877OTHERMIM-CARE
62505015251OTHERMIBCN

General Provider Information

NPI Number : 1134127459
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEOFFREY K SEIDEL MD
Provider Business Mailing Address
First Line : 43555 DALCOMA DR
Second Line : SUITE 4
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-6310
Country : US
Telephone Number : 586-228-2882
Fax Number : 586-463-7152
Provider Business Practice Location Address
First Line : 43555 DALCOMA DR
Second Line : SUITE 4
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-6310
Country : US
Telephone Number : 586-228-2882
Fax Number : 586-463-7152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 11/19/2009

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Directions to “ DR. GEOFFREY K SEIDEL MD” Practice Location

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