Provider Demographics
NPI:1447331244
Name:SEDDON, JOHN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:SEDDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TILGHMAN DR
Mailing Address - Street 2:SUITE 722
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-0007
Mailing Address - Country:US
Mailing Address - Phone:910-892-1068
Mailing Address - Fax:910-892-4527
Practice Address - Street 1:700 TILGHMAN DR
Practice Address - Street 2:SUITE 722
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-0007
Practice Address - Country:US
Practice Address - Phone:910-892-1068
Practice Address - Fax:910-892-4527
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22319208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8975179Medicaid
NC203571AMedicare ID - Type Unspecified
NC8975179Medicaid