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Individual

JASON P SEAMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-1680
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-5325
(616) 391-1680
(616) 285-0846

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
5101015085
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
34.008727
OH
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101015085
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4572551
MI
Enumeration date
09/13/2005
Last updated
04/27/2012
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