Provider Demographics
NPI:1164596615
Name:KURTER, SELAHATTIN S (MD)
Entity Type:Individual
Prefix:DR
First Name:SELAHATTIN
Middle Name:S
Last Name:KURTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6419S HOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-1103
Mailing Address - Country:US
Mailing Address - Phone:414-304-5713
Mailing Address - Fax:414-304-5721
Practice Address - Street 1:1661 N WATER ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2085
Practice Address - Country:US
Practice Address - Phone:414-273-1209
Practice Address - Fax:414-273-1424
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI47803-0202084P0800X, 208D00000X
WI47803-20207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000101686Medicare PIN