Individual
JOHN WADE SEEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
204 E CHESTER PK, SUITE 4, RIDLEY PARK, PA 19078-1709
(610) 521-4677
(610) 521-0951
Mailing address
204 E CHESTER PK, SUITE 4, RIDLEY PARK, PA 19078-1709
(610) 521-4677
(610) 521-0951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD027831E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055283000
KEYSTONE
PA
01
—
1031213
KEYSTONE MERCY
PA
01
—
110075785
TRAVELERS MEDICARE
PA
01
—
195833
BLUE SHIELD
PA
01
—
20-3370210
TAX ID
PA
01
—
55442
AETNA
PA
01
—
C33268
NEIC
PA
Enumeration date
09/15/2005
Last updated
02/04/2015
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