Basic Information
| Provider Information | |||||||||
| NPI: | 1477116796 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEAH | ||||||||
| FirstName: | DENYSE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 424 WARDS CORNER RD STE 20 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451406908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135767700 | ||||||||
| FaxNumber: | 5135761020 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 RIVER VALLEY BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW RICHMOND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451578566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135533114 | ||||||||
| FaxNumber: | 5135531032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2019 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 34015687 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0488455 | 05 | OH | MEDICAID |