Provider Demographics
NPI:1437118882
Name:SEYMORE, CATHY (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:
Last Name:SEYMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:1021 MOREHEAD MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2839
Practice Address - Country:US
Practice Address - Phone:704-355-2272
Practice Address - Fax:704-355-1865
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390842085R0001X
SC132052085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC132056Medicaid
NC26024OtherPARTNERS
NC1135144OtherUNITED HEALTHCARE
NC1577674009OtherCIGNA
NC75257OtherBLUE CROSS
NC62139OtherMEDCOST
NC8975257Medicaid
NC2155157EMedicare ID - Type UnspecifiedLAKE NORMAN RAD ONC CTR
NC2155157CMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR
NC1577674009OtherCIGNA
SCP00306176Medicare ID - Type UnspecifiedRAILROAD
SC132056Medicaid
NC8975257Medicaid
NC75257OtherBLUE CROSS