Provider Demographics
NPI:1265742779
Name:H MICHAEL SELTZER MD PA
Entity type:Organization
Organization Name:H MICHAEL SELTZER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-788-4644
Mailing Address - Street 1:804 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4931
Mailing Address - Country:US
Mailing Address - Phone:386-788-4644
Mailing Address - Fax:
Practice Address - Street 1:804 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4931
Practice Address - Country:US
Practice Address - Phone:386-788-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30839207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD86196Medicare UPIN
FLFQ447AMedicare PIN