Provider Demographics
NPI:1710010871
Name:SEAVER, LINDA EDITH (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:EDITH
Last Name:SEAVER
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 1:4223 E NISBET RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-8119
Mailing Address - Country:US
Mailing Address - Phone:623-670-0744
Mailing Address - Fax:
Practice Address - Street 1:4223 E NISBET RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-8119
Practice Address - Country:US
Practice Address - Phone:623-670-0744
Practice Address - Fax:602-404-0546
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17635208800000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE28404Medicare UPIN