Provider Demographics
NPI:1679688576
Name:SELIGA, ROSE MARY (MD)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARY
Last Name:SELIGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W EXCHANGE ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1704
Mailing Address - Country:US
Mailing Address - Phone:330-344-6072
Mailing Address - Fax:330-344-6447
Practice Address - Street 1:224 W EXCHANGE ST
Practice Address - Street 2:SUITE 330
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1704
Practice Address - Country:US
Practice Address - Phone:330-344-6072
Practice Address - Fax:330-344-6447
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH056706174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3591290001OtherCIGNA
OH53809OtherQUALCHOICE
OH000000129549OtherANTHEM
OH0748936Medicaid
OH3100099OtherUNITED HEALTHCARE
OHP00099680OtherRAIL ROAD MEDICARE
OHF05174Medicare UPIN
OH0748936Medicaid