Provider Demographics
NPI:1760550974
Name:SEILER, MARIE R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:R
Last Name:SEILER
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 1:7111 NORTH MAIN ST
Mailing Address - Street 2:SUITE 50
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2565
Mailing Address - Country:US
Mailing Address - Phone:937-277-6595
Mailing Address - Fax:937-277-6998
Practice Address - Street 1:7111 NORTH MAIN ST
Practice Address - Street 2:SUITE 50
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2565
Practice Address - Country:US
Practice Address - Phone:937-277-6595
Practice Address - Fax:937-277-6998
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH158106208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0784923Medicaid
SE0660381Medicare ID - Type Unspecified
OH0784923Medicaid