Provider Demographics
NPI:1740437425
Name:SEIDENVERG, NORMAN FRANKLIN (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:FRANKLIN
Last Name:SEIDENVERG
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 1:1844 VERVAIS AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4108
Mailing Address - Country:US
Mailing Address - Phone:707-642-2364
Mailing Address - Fax:707-642-2364
Practice Address - Street 1:2030 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6208
Practice Address - Country:US
Practice Address - Phone:707-253-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG92752083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine