Provider Demographics
NPI:1194806448
Name:SEHL, GEORGE SAMUEL (DPM)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:SAMUEL
Last Name:SEHL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 S GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1742
Mailing Address - Country:US
Mailing Address - Phone:319-337-2021
Mailing Address - Fax:319-337-8411
Practice Address - Street 1:805 S GILBERT ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1742
Practice Address - Country:US
Practice Address - Phone:319-337-2021
Practice Address - Fax:319-337-8411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0110122Medicaid
IAU31834Medicare UPIN
IA15973Medicare ID - Type Unspecified