Provider Demographics
NPI:1194797225
Name:SEIDMAN, AIMEE JANE (MD)
Entity type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:JANE
Last Name:SEIDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12806 DOE LN
Mailing Address - Street 2:
Mailing Address - City:DARNESTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6105
Mailing Address - Country:US
Mailing Address - Phone:301-455-8792
Mailing Address - Fax:301-926-4251
Practice Address - Street 1:15020 SHADY GROVE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3364
Practice Address - Country:US
Practice Address - Phone:301-545-1811
Practice Address - Fax:301-545-1814
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD37801207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE65578Medicare ID - Type Unspecified