Basic Information
| Provider Information | |||||||||
| NPI: | 1053309880 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEALS | ||||||||
| FirstName: | EUGENE | ||||||||
| MiddleName: | OAKIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 HOUGHTON AVE | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486025303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895836800 | ||||||||
| FaxNumber: | 9895836955 | ||||||||
| Practice Location | |||||||||
| Address1: | 1575 CONCENTRIC BLVD | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486049312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895836800 | ||||||||
| FaxNumber: | 9895836955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301060692 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 102552 | 01 | GREAT LAKES HEALTH PLAN | OTHER | 0982444 | 01 | MI | HEALTHPLUS OF MICHIGAN | OTHER | 1012085 | 01 | MCLAREN HEALTH PLAN | OTHER | 381908328 | 01 | TRICARE | OTHER | P90583 | 01 | MI | BLUE CARE NETWORK | OTHER | 1012085 | 01 | HEALTH ADVANTAGE PPO | OTHER | 080G310660 | 01 | MI | BCBS | OTHER | 303 | 01 | MI | COMMUNITY CHOICE | OTHER | 381908328 | 01 | PPOM | OTHER | 4686650 | 05 | MI | MEDICAID | 381908328 | 01 | HCAP | OTHER | 4686650 | 01 | MI | MOLINA HEALTH CARE OF MI | OTHER | 7729026 | 01 | AETNA | OTHER |