Provider Demographics
NPI:1023189420
Name:SELEME, VENUS A (DC)
Entity Type:Individual
Prefix:DR
First Name:VENUS
Middle Name:A
Last Name:SELEME
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10395 DEMOCRACY LN STE A
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2540
Mailing Address - Country:US
Mailing Address - Phone:703-273-0573
Mailing Address - Fax:703-273-7056
Practice Address - Street 1:10395 DEMOCRACY LN STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2540
Practice Address - Country:US
Practice Address - Phone:703-273-0573
Practice Address - Fax:703-273-7056
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001957111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC490746OtherMEDICARE ID
VA115039OtherANTHEM
VA115039OtherANTHEM