Provider Demographics
NPI:1861212490
Name:SETON MEDICAL GROUP, INC
Entity type:Organization
Organization Name:SETON MEDICAL GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:HIGGINBOTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-234-3162
Mailing Address - Street 1:4 EAST ROLLING CROSSROADS
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6627
Mailing Address - Country:US
Mailing Address - Phone:410-744-9073
Mailing Address - Fax:
Practice Address - Street 1:4 EAST ROLLING CROSSROADS
Practice Address - Street 2:SUITE 110
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6627
Practice Address - Country:US
Practice Address - Phone:410-744-9073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-17
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty