Provider Demographics
NPI:1659326940
Name:ROBERT M SELIG MD T A ANDORRA PEDIATRICS
Entity Type:Organization
Organization Name:ROBERT M SELIG MD T A ANDORRA PEDIATRICS
Other - Org Name:ANDORRA PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SELIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD FAAP
Authorized Official - Phone:215-483-8558
Mailing Address - Street 1:8945 RIDGE AVENUE
Mailing Address - Street 2:SUITES 3 4 & 5
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2036
Mailing Address - Country:US
Mailing Address - Phone:215-483-8558
Mailing Address - Fax:215-487-1270
Practice Address - Street 1:8945 RIDGE AVENUE
Practice Address - Street 2:SUITES 3 4 & 5
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2036
Practice Address - Country:US
Practice Address - Phone:215-483-8558
Practice Address - Fax:215-487-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty