Provider Demographics
NPI:1629485503
Name:SEIDLER, MOLLY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:E
Last Name:SEIDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 STAUNTON AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1327
Mailing Address - Country:US
Mailing Address - Phone:304-388-6004
Mailing Address - Fax:304-388-3360
Practice Address - Street 1:UNIVERSITY OF KENTUCKY
Practice Address - Street 2:800 ROSE ST.
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-12
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28122207P00000X
KYR3668207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine