| Doctor Name: | DR. KEVIN SEO |
| NPI Number: | 1336340975 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 020995 |
| Business Practice Address: | 9124 George Ave Apt 24 Berrien Springs, MI - 491031659 |
| Business Phone Number: | 2195885409 |
| Business Fax Number: | |
| Mailing Address: | 9124 George Ave Apt 24, BERRIEN SPRINGS |
| State: | MI |
| Postal Code: | 491031659 |
| Phone Number: | 2195885409 |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 08/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 020995 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |