MEDICARE: JOHN JOSEPH SEIDENFELD M.D.

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	207RP1001X	Pulmonary Disease Physician	G6393	TX

General Provider Information

NPI Number	:	1336321686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JOSEPH SEIDENFELD M.D.

Provider Business Mailing Address
First Line	:	SUITE 703 414 NAVARRO
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2515
Country	:	US
Telephone Number	:	210-224-4811
Fax Number	:	210-224-8678

Provider Business Practice Location Address
First Line	:	SUITE 703 414 NAVARRO
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2515
Country	:	US
Telephone Number	:	210-224-4811
Fax Number	:	210-224-8678

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

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	02/08/2008

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