Provider Demographics
NPI:1538592415
Name:SEYER, MATTHEW R (PHARMD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:SEYER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 DONNA ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1588
Mailing Address - Country:US
Mailing Address - Phone:608-988-6545
Mailing Address - Fax:
Practice Address - Street 1:245 W CALUMET ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-1637
Practice Address - Country:US
Practice Address - Phone:902-849-2818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17108-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist