Provider Demographics
NPI:1811104789
Name:SEYMOUR, BRIDGET JENNINGS (MD)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:JENNINGS
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:140 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6700
Mailing Address - Country:US
Mailing Address - Phone:978-420-1530
Mailing Address - Fax:978-420-1064
Practice Address - Street 1:62 BROWN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6778
Practice Address - Country:US
Practice Address - Phone:978-420-1530
Practice Address - Fax:978-420-1064
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2010-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT182139207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110083659AMedicaid
001317001Medicare PIN