Provider Demographics
NPI:1346341526
Name:SEAVERS, RAYMER WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMER
Middle Name:WILLIAM
Last Name:SEAVERS
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 1:1302 E 32ND ST
Mailing Address - Street 2:VA COMMUNITY CLINIC
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7252
Mailing Address - Country:US
Mailing Address - Phone:505-538-2921
Mailing Address - Fax:505-388-9260
Practice Address - Street 1:1302 E 32ND ST
Practice Address - Street 2:VA COMMUNITY CLINIC
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7252
Practice Address - Country:US
Practice Address - Phone:505-538-2921
Practice Address - Fax:505-388-9260
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM83-107208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD43298Medicare ID - Type Unspecified
NMAV4607668-016Medicare ID - Type UnspecifiedVA NUMBER