Provider Demographics
NPI:1649317694
Name:SEIBEL, PHILIP ALAN (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:ALAN
Last Name:SEIBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PENNSYLVANIA AVE SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2167
Mailing Address - Country:US
Mailing Address - Phone:202-608-4756
Mailing Address - Fax:202-608-4284
Practice Address - Street 1:801 PENNSYLVANIA AVE SE
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2167
Practice Address - Country:US
Practice Address - Phone:202-608-4756
Practice Address - Fax:202-608-4284
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 161462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0419930Medicaid
DC5123OtherHEALTHRIGHT
DC21999OtherCHARTERED HEALTH
DC281899OtherAMERIGROUP
DC281899OtherAMERIGROUP
DC0419930Medicaid