Provider Demographics
NPI:1992968812
Name:SEALS MEDICAL CARE, PC
Entity type:Organization
Organization Name:SEALS MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-799-2632
Mailing Address - Street 1:2002 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3703
Mailing Address - Country:US
Mailing Address - Phone:989-799-2632
Mailing Address - Fax:989-799-2642
Practice Address - Street 1:2002 COURT ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3703
Practice Address - Country:US
Practice Address - Phone:989-799-2632
Practice Address - Fax:989-799-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty