Provider Demographics
NPI:1245200161
Name:SEEMULLER, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:SEEMULLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 HIGHWAY 81 NORTH
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673
Mailing Address - Country:US
Mailing Address - Phone:864-512-5910
Mailing Address - Fax:864-512-5915
Practice Address - Street 1:6650 HIGHWAY 81 NORTH
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673
Practice Address - Country:US
Practice Address - Phone:864-512-5910
Practice Address - Fax:864-512-5915
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-234556207Q00000X
SC22632207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005646952Medicaid
VA005646952Medicaid
SCH560377043Medicare PIN
001382C85Medicare ID - Type Unspecified
VA017937C18Medicare PIN