Provider Demographics
NPI:1649869421
Name:SEABERG, ROBERT DAVID
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
Last Name:SEABERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-2368
Mailing Address - Country:US
Mailing Address - Phone:781-871-3331
Mailing Address - Fax:781-871-3331
Practice Address - Street 1:932 N MONTELLO ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1694
Practice Address - Country:US
Practice Address - Phone:508-427-6582
Practice Address - Fax:508-427-6977
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist