Provider Demographics
NPI:1275684011
Name:SELTZER, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SELTZER
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 1:4240 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6612
Mailing Address - Country:US
Mailing Address - Phone:513-891-0650
Mailing Address - Fax:513-891-2838
Practice Address - Street 1:4240 HUNT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-6612
Practice Address - Country:US
Practice Address - Phone:513-891-0650
Practice Address - Fax:513-891-2838
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350380472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH012297000OtherMAGELLAN PROVIDER NUMBER
OH311705723OtherEIN
OH4135961Medicare ID - Type Unspecified
OHA75790Medicare UPIN