Provider Demographics
NPI:1245559392
Name:STEPHEN M. SEABRON, MD, PC
Entity Type:Organization
Organization Name:STEPHEN M. SEABRON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEABRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-526-8898
Mailing Address - Street 1:1140 VARNUM ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2151
Mailing Address - Country:US
Mailing Address - Phone:202-526-8898
Mailing Address - Fax:202-529-4537
Practice Address - Street 1:1140 VARNUM ST NE STE 209
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2153
Practice Address - Country:US
Practice Address - Phone:202-526-8898
Practice Address - Fax:202-529-4537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC025275500Medicaid
DC025275500Medicaid
DC194095Medicare PIN