Provider Demographics
NPI:1144390089
Name:SEAQUIST, ELIZABETH RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RACHEL
Last Name:SEAQUIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 DELAWARE STREET SE, MMC 101
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-625-8690
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE STREET SE, CLINIC 6A
Practice Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-625-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27981207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
1009304OtherPREFERRED ONE
WI31620900Medicaid
5T602SEOtherBLUE CROSS BLUE SHIELD
3324560OtherMEDICA CHOICE
MT0051663Medicaid
IA0500470Medicaid
33-74530OtherMEDICA PRIMARY
MN577277000Medicaid
101015OtherUCARE
768338OtherARAZ
HP22062OtherHEALTH PARTNERS
MT0051663Medicaid
768338OtherARAZ
460000105Medicare ID - Type Unspecified