Provider Demographics
NPI:1063449460
Name:SELTZER, KIMBERLY (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:SELTZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 WESLEY AVE
Mailing Address - Street 2:STE N
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2298
Mailing Address - Country:US
Mailing Address - Phone:513-246-7796
Mailing Address - Fax:513-246-7855
Practice Address - Street 1:2001 ANDERSON FERRY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3325
Practice Address - Country:US
Practice Address - Phone:513-246-7000
Practice Address - Fax:513-246-5627
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044344Medicaid
OHSE0814856Medicare PIN
OHG40399Medicare UPIN