Provider Demographics
NPI:1568433902
Name:SELTZER, JAY R (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:R
Last Name:SELTZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 78429
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63178-8429
Mailing Address - Country:US
Mailing Address - Phone:314-548-0265
Mailing Address - Fax:314-548-6555
Practice Address - Street 1:456 N NEW BALLAS RD STE 348
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6846
Practice Address - Country:US
Practice Address - Phone:314-548-0265
Practice Address - Fax:314-548-6555
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOMDR8H64207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E43832Medicare UPIN