Doctor Name: | DR. SETH TATEL |
NPI Number: | 1144433467 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 125050091 |
Business Practice Address: | 901 Lincolnway Suite 306 La Porte, IN - 463503430 |
Business Phone Number: | 2193240875 |
Business Fax Number: | 2193240827 |
Mailing Address: | Po Box 1690, LA PORTE |
State: | IN |
Postal Code: | 463521690 |
Phone Number: | 2193262312 |
Fax Number: | 2193262584 |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 12/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 125050091 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |