Provider Demographics
NPI:1285631226
Name:SEELINGER, GRETCHEN ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:ELAINE
Last Name:SEELINGER
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 1:3410 INDIAN SCHOOL RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1148
Mailing Address - Country:US
Mailing Address - Phone:505-265-7817
Mailing Address - Fax:505-266-1543
Practice Address - Street 1:3410 INDIAN SCHOOL RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1148
Practice Address - Country:US
Practice Address - Phone:505-265-7817
Practice Address - Fax:505-266-1543
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM81-314208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM35865Medicaid
NM35865Medicaid