Provider Demographics
NPI:1235124041
Name:SEAWARD, EDMUND A (OD)
Entity Type:Individual
Prefix:
First Name:EDMUND
Middle Name:A
Last Name:SEAWARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-3658
Mailing Address - Country:US
Mailing Address - Phone:515-262-7555
Mailing Address - Fax:515-262-4423
Practice Address - Street 1:2472 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317-3658
Practice Address - Country:US
Practice Address - Phone:515-262-7555
Practice Address - Fax:515-262-4423
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1652152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
42106102728OtherJ DEERE HEALTH
IA1139477Medicaid
2200200OtherUNITED HEALTH CARE
2200200OtherUNITED HEALTH CARE
T00847Medicare UPIN