Robert Seiberlich, NMD, LMT

Individual provider Active NPI General Practice Physician · Ponderay, ID

NPI 1801468608 · NPPES record last updated Mar 18, 2025

Key facts

NPI
1801468608
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
NMD-0036 (ID)
Practice address
550 Larkspur St Apt B203
Ponderay, ID 83852-5018
Phone
(360) 801-4888
NPI assigned
Jul 13, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
NMD-0036IDMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X
General Practice Physician 208D00000X NMD-0036 ID Yes

Addresses

Primary practice location

550 Larkspur St Apt B203
Ponderay, ID 83852-5018

Mailing address

550 Larkspur St Apt B203
Ponderay, ID 83852-5018

Other providers in Ponderay, ID

All providers in Ponderay, ID · General Practice Physician in Idaho

Sources for this page

Verify at the official NPI Registry.