Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR.0055302 | CO |
N | 207X00000X | Orthopaedic Surgeon | ML60164018 | WA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | DR.0055302 | CO |
NPI | 1376869610 |
---|---|
Provider Name | Courtney Michelle Selberg |
First Address | Denver, CO 80203-2457 |
Second Address | Aurora, CO 80045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 19/06/2020 |