Provider Demographics
NPI:1356476113
Name:SEAMAN, KEVIN GERARD (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:GERARD
Last Name:SEAMAN
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 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:8105 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-3905
Practice Address - Country:US
Practice Address - Phone:443-573-0564
Practice Address - Fax:443-573-0565
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044726207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD554866ZDDBMedicare PIN
MD554866YVZMedicare PIN
MD541673YWV2Medicare PIN