Provider Demographics
NPI:1578524955
Name:SEDLAK, MICHAEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:SEDLAK
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 1:876 LOOP 337
Mailing Address - Street 2:#302
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130
Mailing Address - Country:US
Mailing Address - Phone:830-625-8088
Mailing Address - Fax:830-629-9215
Practice Address - Street 1:876 LOOP 337
Practice Address - Street 2:#302
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:830-625-8088
Practice Address - Fax:830-629-9215
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-055513-L174400000X
TXM7608208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20010385OtherAMERIHEALTH MERCY
PA2Y8350OtherHEALTHNET
PA000000075924OtherMEDPLUS
PA505911OtherAETNA USHEALTHCARE
PA0016499110003Medicaid
PA34369OtherBLUE SHIELD
PA990006365OtherTRAVELER'S RAILROAD MEDIC
DC01042701OtherCAPITAL BLUE CROSS
PA24372 6365OtherGEISINGER HEALTH PLAN
PAG50907Medicare UPIN
TXG50907Medicare UPIN
PA950227ECLMedicare ID - Type Unspecified