Provider Demographics
NPI:1578552006
Name:SEAMON, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:SEAMON
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 1:15 CLEVELAND AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2937
Mailing Address - Country:US
Mailing Address - Phone:276-632-9714
Mailing Address - Fax:276-632-0620
Practice Address - Street 1:15 CLEVELAND AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2937
Practice Address - Country:US
Practice Address - Phone:276-632-9714
Practice Address - Fax:276-632-0620
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2012-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044935208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA099029OtherBLUE CROSS
VA6727304Medicaid
VA099029OtherBLUE CROSS