Provider Demographics
NPI:1043990302
Name:SETH, VYUKUSENGE PHILOGENE
Entity Type:Individual
Prefix:
First Name:VYUKUSENGE
Middle Name:PHILOGENE
Last Name:SETH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 BILOXI AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-5555
Mailing Address - Country:US
Mailing Address - Phone:251-251-2955
Mailing Address - Fax:
Practice Address - Street 1:6011 BILOXI AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-5555
Practice Address - Country:US
Practice Address - Phone:251-295-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver