Provider Demographics
NPI:1669574364
Name:SEIBEL, DAVID LAMAR (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAMAR
Last Name:SEIBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3268 N DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-1616
Mailing Address - Country:US
Mailing Address - Phone:856-696-3908
Mailing Address - Fax:856-563-1918
Practice Address - Street 1:3268 N DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-1616
Practice Address - Country:US
Practice Address - Phone:856-696-3908
Practice Address - Fax:856-563-1918
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03080700208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
222144302OtherFED ID
NJ2424509Medicaid
NJD18525Medicare UPIN
094724Medicare ID - Type Unspecified