Individual
SEANN ELISE WILLSON
Active
Individual
SEANN ELISE WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301091485
MI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
4301091485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0251416
BCBSM
MI
01
—
0N45090
MEDICARE GROUP PTAN
MI
05
—
1033236823
—
MI
Enumeration date
03/25/2007
Last updated
01/11/2012
Update your record
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