Provider Demographics
NPI:1285758532
Name:RONALD A SEFF, MD, PA
Entity type:Organization
Organization Name:RONALD A SEFF, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-574-4040
Mailing Address - Street 1:19 FONTANA LN
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3047
Mailing Address - Country:US
Mailing Address - Phone:410-574-4040
Mailing Address - Fax:410-574-1255
Practice Address - Street 1:19 FONTANA LN
Practice Address - Street 2:SUITE 108
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3047
Practice Address - Country:US
Practice Address - Phone:410-574-4040
Practice Address - Fax:410-574-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD16254207W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD938QOtherMEDICARE P TEN
MD3103013P0000Medicaid
MD1260380001Medicare NSC
MDB70183Medicare UPIN