Provider Demographics
NPI:1295841179
Name:GOMEZ-SEOANE, SILVIA T (MD)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:T
Last Name:GOMEZ-SEOANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SILVIA
Other - Middle Name:
Other - Last Name:SEOANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5060 VILLA LINDE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3411
Mailing Address - Country:US
Mailing Address - Phone:810-733-5060
Mailing Address - Fax:810-733-7870
Practice Address - Street 1:5060 VILLA LINDE PARKWAY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3411
Practice Address - Country:US
Practice Address - Phone:810-733-5060
Practice Address - Fax:810-733-7870
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISG407339207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0252816Medicare ID - Type Unspecified
F2002Medicare UPIN
0252816Medicare PIN