Kevin Seo, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

020995 Issued in PR

Practice address

9124 George Ave Apt 24
Berrien Springs, MI 49103-1659

Phone

(219) 588-5409

NPI assigned

May 30, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vega Alta Community Health

  • Clinical Medical Laboratory
  • Vega Alta, PR
  • NPI 1952338154
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1336340975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9124 GEORGE AVE APT 24",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031659",
            "telephone_number": "219-588-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9124 GEORGE AVE APT 24",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031659",
            "telephone_number": "219-588-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "020995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn M. Schafer, M.A.
• Brenda Schalk, RD
• Shelley Schmaltz
• Denise Diane Schmidtmcclintock, MSW LLSW
• David Herbert Schug, BS RPH
• Robert Sepulveda, LPC
• Kathleen Joann Shafer, LMSW
• Rahul Chaitanya Shah
• Shangrila Home
• Lars Sherburn

• General Practice Physician in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.