Individual
MARY B. SEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
829 N CENTER AVE, SUITE 140, GAYLORD, MI 49735-1595
(989) 731-7870
(989) 731-7837
Mailing address
829 N CENTER AVE, SUITE 298, GAYLORD, MI 49735-1595
(989) 731-7708
(989) 731-7929
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
47404155037
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156900045
BCBSM PROVIDER NUMBER
MI
01
—
381303843
TAX ID
—
01
—
CC4805
MEDICARE RR PROV ID
—
01
—
OF96004
MEDICARE GROUP NUMBER
—
Enumeration date
07/06/2006
Last updated
12/03/2013
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