Provider Demographics
NPI:1376523399
Name:SEIDEL, MATTHEW J (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:SEIDEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9700 N 91ST ST
Mailing Address - Street 2:STE B108
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5036
Mailing Address - Country:US
Mailing Address - Phone:602-258-8500
Mailing Address - Fax:602-285-8510
Practice Address - Street 1:4614 E SHEA BLVD
Practice Address - Street 2:SUITE D-160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3070
Practice Address - Country:US
Practice Address - Phone:602-258-8500
Practice Address - Fax:602-258-8510
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2017-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ32887207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ960874Medicaid
101963Medicare ID - Type Unspecified
AZ960874Medicaid