Provider Demographics
NPI:1225214240
Name:KING-SELARIO, NATALIE R (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:R
Last Name:KING-SELARIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1370 JOHNSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1688
Mailing Address - Country:US
Mailing Address - Phone:304-842-3330
Mailing Address - Fax:304-842-3303
Practice Address - Street 1:1370 JOHNSON AVENUE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1688
Practice Address - Country:US
Practice Address - Phone:304-842-3330
Practice Address - Fax:304-842-3303
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV2264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine