Provider Demographics
NPI:1285816173
Name:PATIL, SEEMA (MD)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:PATIL
Suffix:
Gender:F
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-706-3387
Mailing Address - Fax:410-706-4330
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-706-3387
Practice Address - Fax:410-706-4330
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72668207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD440601000Medicaid
MD974687-01OtherCAREFIRST BC/BS
MDS062-0437OtherCAREFIRST BC/BS - REGIONAL
MDS062-0437OtherCAREFIRST BC/BS - REGIONAL