Provider Demographics
NPI:1952438384
Name:SEIVERLING, ELIZABETH V (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:V
Last Name:SEIVERLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VINNY
Other - Middle Name:
Other - Last Name:SEIVERLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1251 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-1643
Mailing Address - Country:US
Mailing Address - Phone:717-988-0580
Mailing Address - Fax:
Practice Address - Street 1:1251 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1643
Practice Address - Country:US
Practice Address - Phone:717-988-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD22090207N00000X
PAMD448202207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0265042OtherL & I
WAG8892683Medicare UPIN