Provider Demographics
NPI:1952075301
Name:SEALS, JEFFERY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:
Last Name:SEALS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 WADE PARK BLVD UNIT 214
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-4248
Mailing Address - Country:US
Mailing Address - Phone:434-660-0864
Mailing Address - Fax:
Practice Address - Street 1:4037 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2516
Practice Address - Country:US
Practice Address - Phone:919-765-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-08
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist