Provider Demographics
NPI:1154314391
Name:SEAVERS, ABRAM TIMOTHY (DPM)
Entity Type:Individual
Prefix:
First Name:ABRAM
Middle Name:TIMOTHY
Last Name:SEAVERS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3524
Mailing Address - Country:US
Mailing Address - Phone:252-946-0342
Mailing Address - Fax:252-948-0558
Practice Address - Street 1:403 W 15TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3524
Practice Address - Country:US
Practice Address - Phone:252-946-0342
Practice Address - Fax:252-948-0558
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5339465OtherAETNA
NC480032852OtherMEDICARE RAILROAD
NC890809FMedicaid
NC0809FOtherBLUE CROSS
NC1493590OtherUNITED HEALTHCARE
NC243103DMedicare PIN
NC5339465OtherAETNA