Provider Demographics
NPI:1700968724
Name:SEAMAN, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:SEAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2160
Mailing Address - Street 2:SANDPOINT PEDIATRICS - KANIKSU HEALTH SERVICES
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0908
Mailing Address - Country:US
Mailing Address - Phone:208-265-2242
Mailing Address - Fax:
Practice Address - Street 1:420 N 2ND AVE
Practice Address - Street 2:SANDPOINT PEDIATRICS - KANIKSU HEALTH SERVICES
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1565
Practice Address - Country:US
Practice Address - Phone:208-265-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-12114208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00717744Medicaid
NY100803DLOtherPREFERRED CARE
NY5260652OtherAETNA
NYP010132608OtherEXCELLUS BC/BS ROCHESTER
NYP010132608OtherEXCELLUS BC/BS ROCHESTER
NY100803DLOtherPREFERRED CARE