Provider Demographics
NPI:1699753681
Name:SEDDON, JOHANNA MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:MARGARET
Last Name:SEDDON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4 LOUISBURG SQ
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-1203
Mailing Address - Country:US
Mailing Address - Phone:617-943-7859
Mailing Address - Fax:617-636-1124
Practice Address - Street 1:10 HAWTHORNE PL STE 106
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2336
Practice Address - Country:US
Practice Address - Phone:617-523-0955
Practice Address - Fax:617-523-5376
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2020-10-27
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Provider Licenses
StateLicense IDTaxonomies
MA38282207W00000X, 207WX0108X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA038282OtherTUFTS HEALTH PLAN
MAB33604OtherBCBS MA
MA6172954Medicaid
MA038282OtherTUFTS HEALTH PLAN
A35882Medicare UPIN