Provider Demographics
NPI:1376869610
Name:SELBERG, COURTNEY MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MICHELLE
Last Name:SELBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MICHELLE
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1159 N LOGAN ST
Mailing Address - Street 2:APT 3
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2457
Mailing Address - Country:US
Mailing Address - Phone:310-529-4602
Mailing Address - Fax:
Practice Address - Street 1:13123 EAST 16TH AVENUE, BOX 060
Practice Address - Street 2:CHILDREN'S HOSPITAL COLORADO- ORTHOPEDICS INSTITUTE
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-777-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0055302207X00000X, 207XP3100X
WAML60164018207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery