Provider Demographics
NPI:1407861297
Name:SEEPE, CAROLYN SUE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:SUE
Last Name:SEEPE
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 1:173 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4101
Mailing Address - Country:US
Mailing Address - Phone:434-791-4110
Mailing Address - Fax:434-791-4003
Practice Address - Street 1:173 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4101
Practice Address - Country:US
Practice Address - Phone:434-791-4110
Practice Address - Fax:434-791-4003
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1407861297OtherNPI
VA010184398Medicaid