Provider Demographics
NPI:1235303504
Name:SELKIN, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SELKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 WINDY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1140
Mailing Address - Country:US
Mailing Address - Phone:704-708-5611
Mailing Address - Fax:704-708-5138
Practice Address - Street 1:2009 MALLORY LN
Practice Address - Street 2:SUITE 220
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2845
Practice Address - Country:US
Practice Address - Phone:888-527-3796
Practice Address - Fax:972-867-2215
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34932207W00000X
TXK6307207W00000X
NC207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology