MEDICARE: TAMMIS N SEIPEL 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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	0101259780	VA

General Provider Information

NPI Number	:	1962454603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMIS N SEIPEL MD

Provider Business Mailing Address
First Line	:	PO BOX 7068
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-0068
Country	:	US
Telephone Number	:	757-686-3508
Fax Number	:	757-686-0541

Provider Business Practice Location Address
First Line	:	1168 FIRST COLONIAL RD
Second Line	:	STE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2444
Country	:	US
Telephone Number	:	757-481-1113
Fax Number	:	757-496-3822

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	03/08/2016

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