Individual
SETH EDWARD ILGENFRITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-3637
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0799
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2012006517
MO
207P00000X
Emergency Medicine Physician
MD61399073
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942524756
—
MO
01
—
440552485
TRICARE
MO
01
—
P01235236 CLINIC
RR MCR
MO
Enumeration date
03/23/2010
Last updated
04/17/2023
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