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NPI Code Detail

MEDICARE: DR. JOHN SEIDL MD

MEDICARE: DR. JOHN SEIDL 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
1207Q00000XFamily Medicine Physician25426WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1002000135BOTHERHUMANA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700838430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN SEIDL MD
Provider Business Mailing Address
First Line : 1121 E NORTH AVE
Second Line : COLUMBIA-ST. MARY'S FAMILY PRACTICE
City : MILWAUKEE
State : WI
Zip : 53212-3515
Country : US
Telephone Number : 414-267-6500
Fax Number : 414-267-3894
Provider Business Practice Location Address
First Line : 1121 E NORTH AVE
Second Line : COLUMBIA-ST. MARY'S FAMILY PRACTICE
City : MILWAUKEE
State : WI
Zip : 53212-3515
Country : US
Telephone Number : 414-267-6500
Fax Number : 414-267-3894
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 03/06/2019

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