Provider Demographics
NPI:1427021443
Name:SELAND, TROND GUNNAR (DC)
Entity Type:Individual
Prefix:DR
First Name:TROND
Middle Name:GUNNAR
Last Name:SELAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 VILLAGE SQUARE LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4555
Mailing Address - Country:US
Mailing Address - Phone:317-598-1410
Mailing Address - Fax:317-598-9807
Practice Address - Street 1:7350 VILLAGE SQUARE LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4555
Practice Address - Country:US
Practice Address - Phone:317-598-1410
Practice Address - Fax:317-598-9807
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5724256OtherAETNA
IN000000092076OtherANTHEM BXBS
IN267750Medicare ID - Type Unspecified