Provider Demographics
NPI:1063489227
Name:SEIM, ROSA HERNANDEZ (MD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:HERNANDEZ
Last Name:SEIM
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 1:5435 FELTL RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-7983
Mailing Address - Country:US
Mailing Address - Phone:952-835-9880
Mailing Address - Fax:952-857-1554
Practice Address - Street 1:6500 EXCELSIOR BLVD
Practice Address - Street 2:METHODIST HOSPITAL
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-993-6080
Practice Address - Fax:952-993-6047
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40143207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN653526700Medicaid
MN40143OtherMN MEDICAL LICENSE
MN40143OtherMN MEDICAL LICENSE
930000855Medicare ID - Type Unspecified