Provider Demographics
NPI:1134183247
Name:SEAVY, GEORGE NEIL (DO)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:NEIL
Last Name:SEAVY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E BROAD ST
Mailing Address - Street 2:BROAD AND CHERRY STREETS
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-2546
Mailing Address - Country:US
Mailing Address - Phone:215-368-3456
Mailing Address - Fax:215-368-5280
Practice Address - Street 1:115 E BROAD ST
Practice Address - Street 2:BROAD AND CHERRY STREETS
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-2546
Practice Address - Country:US
Practice Address - Phone:215-368-3456
Practice Address - Fax:215-368-5280
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05012690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101323680001Medicaid
PA1732831OtherPA BLUE SHIELD
PA101323680001Medicaid
I24670Medicare UPIN