Provider Demographics
NPI:1598170797
Name:SEAGROVE, MAIGHAN A (DO)
Entity type:Individual
Prefix:DR
First Name:MAIGHAN
Middle Name:A
Last Name:SEAGROVE
Suffix:
Gender:
Credentials:DO
Other - Prefix:DR
Other - First Name:MAIGHAN
Other - Middle Name:
Other - Last Name:SEAGROVE-GUFFEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5616 BRAINERD RD STE 208
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5376
Mailing Address - Country:US
Mailing Address - Phone:423-265-3561
Mailing Address - Fax:
Practice Address - Street 1:5616 BRAINERD RD STE 208
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5376
Practice Address - Country:US
Practice Address - Phone:423-265-3561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01390207R00000X
GA78413207R00000X
TN57442083B0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNN4558COtherMEDICARE