Individual
DR. PETER ANDREW SEYMOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PETER SEYMOUR D.O.
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
(765) 448-7613
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
02003722A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036.119603
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000669885
ANTHEM PROVIDER NUMBER
IN
05
—
200989810
—
IN
Enumeration date
02/13/2009
Last updated
02/24/2021
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