Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD12377 | OR |
NPI | 1043216088 |
---|---|
Provider Name | Dr. Daniel S Selinger |
First Address | Grants Pass, OR 97527 |
Second Address | Grants Pass, OR 97527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
237461 | (05) | OR |
C91975 | (02) |