Provider Demographics
NPI:1437958980
Name:SETON MEDICAL GROUP, INC
Entity type:Organization
Organization Name:SETON MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:HIGGINGBOTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-234-3162
Mailing Address - Street 1:6740 ALEXANDER BELL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2248
Mailing Address - Country:US
Mailing Address - Phone:410-644-2582
Mailing Address - Fax:410-644-6232
Practice Address - Street 1:6740 ALEXANDER BELL DR STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2248
Practice Address - Country:US
Practice Address - Phone:410-644-2582
Practice Address - Fax:410-644-6232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty