Organization Active NPI

Paola M Seidel M D PLLC

  • Physical Medicine & Rehabilitation Physician
  • Berkley, MI
National Provider Identifier
1912401001
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301058096 Issued in MI
Legal business name
PAOLA M SEIDEL M D PLLC
Practice address
2615 W 12 Mile Rd
Berkley, MI 48072-1627
Phone
(248) 850-7068
Fax
(248) 850-7112
NPI assigned
Mar 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Paola M Seidel, MD
Title
Provider
Phone
(248) 850-7068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 4301058096 MI Primary

Addresses

Primary practice location

2615 W 12 Mile Rd
Berkley, MI 48072-1627

Mailing address

2615 W 12 Mile Rd
Berkley, MI 48072-1627
Phone (248) 850-7068

National Provider Directory

National Provider Directory

Locations

2615 W 12 Mile Rd
Berkley, MI 48072
Phone (248) 397-4705

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1912401001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 W 12 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721627",
            "telephone_number": "248-850-7068",
            "fax_number": "248-850-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 W 12 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721627",
            "telephone_number": "248-850-7068",
            "fax_number": "248-850-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAOLA M SEIDEL M D PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "SEIDEL",
        "authorized_official_first_name": "PAOLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "248-850-7068",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301058096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.