MEDICARE: DR. KEVIN MICHAEL SEYFRIED RPH, PHARMD

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
1	183500000X	Pharmacist	RPH. 03131785	OH

General Provider Information

NPI Number	:	1134484678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN MICHAEL SEYFRIED RPH, PHARMD

Provider Business Mailing Address
First Line	:	4925 JACKMAN RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3574
Country	:	US
Telephone Number	:	419-475-9103
Fax Number	:	419-474-2492

Provider Business Practice Location Address
First Line	:	4925 JACKMAN RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3574
Country	:	US
Telephone Number	:	419-475-9103
Fax Number	:	419-474-2492

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	10/10/2012

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