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Individual
SETH EDWARD ILGENFRITZ
Active
Individual
SETH EDWARD ILGENFRITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2012006517
MO
207P00000X
Emergency Medicine Physician
MD61399073
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942524756
—
MO
01
—
440552485
TRICARE
MO
01
—
P01235236 CLINIC
RR MCR
MO
Enumeration date
03/23/2010
Last updated
04/17/2023
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