Provider Demographics
NPI:1205873833
Name:SEIBEL, MARY J (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:SEIBEL
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 1:55 COUNTRY CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-3623
Mailing Address - Country:US
Mailing Address - Phone:508-358-6601
Mailing Address - Fax:
Practice Address - Street 1:354 WAVERLY ST
Practice Address - Street 2:PARTNERSHIP OR GROUP PRACTICE
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7079
Practice Address - Country:US
Practice Address - Phone:508-270-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49772207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine