Provider Demographics
NPI:1366434177
Name:SEILER, PATRICIA ANNE (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:SEILER
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 1:551 LINN ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-1595
Mailing Address - Country:US
Mailing Address - Phone:269-686-5800
Mailing Address - Fax:269-686-5899
Practice Address - Street 1:551 LINN ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1595
Practice Address - Country:US
Practice Address - Phone:269-686-5877
Practice Address - Fax:269-686-5896
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301044797207Q00000X, 207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI044797OtherSTATE LICENSE NUMBER
MI4819980Medicaid
MI0800311681OtherBLUE BROSS BLUE SHEILD OF
MI01-31432OtherPHP
MI37533OtherHEALTH PLAN OF MI
MIP39040017Medicare PIN
MI37533OtherHEALTH PLAN OF MI