Provider Demographics
NPI:1639160963
Name:SEIBEL, KATHLEEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:SEIBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:ECU PHYSICIANS
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 JOHNS HOPKINS DRIVE
Practice Address - Street 2:ECU PHYSICIANS PSYCHIATRIC MEDICINE - OUTPATIENT CLINIC
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7225
Practice Address - Country:US
Practice Address - Phone:252-744-1406
Practice Address - Fax:252-744-2419
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC308562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC75211OtherBCBS NC
NC8975211Medicaid
NC990015450OtherRAILROAD MEDICARE
NC8975211Medicaid
NC213639DMedicare PIN