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Individual

MARK E SEIB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1675 N MAIN ST, LAPEL, IN 46051-9671
(765) 534-3127
(765) 534-3022
Mailing address
1675 N MAIN ST, LAPEL, IN 46051-9671
(765) 534-3127
(765) 534-3022

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045786A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000312907
ANTHEM
IN
05
200225440
IN
01
P00167936
RR MEDICARE
IN
01
P01014116
RR MEDICARE PTAN
IN
Enumeration date
07/26/2006
Last updated
04/27/2012
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