Provider Demographics
NPI:1548279078
Name:CRAIG SEICSHNAYDRE, APMC
Entity type:Organization
Organization Name:CRAIG SEICSHNAYDRE, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/EXECUTIVE
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEICSHNAYDRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-727-1855
Mailing Address - Street 1:PO BOX 0669
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-0669
Mailing Address - Country:US
Mailing Address - Phone:985-542-2653
Mailing Address - Fax:985-662-0720
Practice Address - Street 1:7014 MEADOW BROOK DRIVE
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-7014
Practice Address - Country:US
Practice Address - Phone:985-542-2653
Practice Address - Fax:985-662-0720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD-022764207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1497886Medicaid
LA1497886Medicaid
5CU82Medicare PIN
LA5CU82Medicare PIN