Provider Demographics
NPI:1609858273
Name:SEUC, CARLOS A (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:SEUC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 1ST CAPITOL DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2880
Mailing Address - Country:US
Mailing Address - Phone:636-946-8700
Mailing Address - Fax:636-946-5094
Practice Address - Street 1:400 1ST CAPITOL DR
Practice Address - Street 2:SUITE 401
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2880
Practice Address - Country:US
Practice Address - Phone:636-946-8700
Practice Address - Fax:636-946-5094
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOMDR7A66207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A10030Medicare UPIN