Provider Demographics
NPI:1578530127
Name:SEIPEL, ANDREW C (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:SEIPEL
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 1:2181 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-8917
Mailing Address - Country:US
Mailing Address - Phone:220-564-1720
Mailing Address - Fax:220-564-1726
Practice Address - Street 1:2181 W HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-8917
Practice Address - Country:US
Practice Address - Phone:220-564-1720
Practice Address - Fax:220-564-1726
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.062845207P00000X
OH35062845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0854419Medicaid
OHH102051Medicare PIN