Provider Demographics
NPI:1073555231
Name:SELTZER, STEPHEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:SELTZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6367 E TANQUE VERDE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3829
Mailing Address - Country:US
Mailing Address - Phone:520-290-5888
Mailing Address - Fax:520-290-5551
Practice Address - Street 1:6367 E TANQUE VERDE RD
Practice Address - Street 2:STE. 200
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3829
Practice Address - Country:US
Practice Address - Phone:520-290-5888
Practice Address - Fax:520-290-5551
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2007-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ6191207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ220179Medicaid
D37622Medicare UPIN
AZ77577Medicare PIN