Provider Demographics
NPI:1669478475
Name:SELTZER, MARLENE BETH (MD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:BETH
Last Name:SELTZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3920 W BIG BEAVER RD
Mailing Address - Street 2:STE 444
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2903
Mailing Address - Country:US
Mailing Address - Phone:248-816-9200
Mailing Address - Fax:248-816-1017
Practice Address - Street 1:3920 W BIG BEAVER RD
Practice Address - Street 2:STE 444
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2903
Practice Address - Country:US
Practice Address - Phone:248-816-9200
Practice Address - Fax:248-816-1017
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2011-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301069851207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI063-26432OtherBCBS
MIP61834OtherBLUE CARE NETWORK
MIC6301OtherMCARE
MIG34926OtherHAP
MIG34926OtherHAP
MIG34926Medicare UPIN