Provider Demographics
NPI:1710325386
Name:SELIO, BRIGITTE R (MD)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:R
Last Name:SELIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIGITTE
Other - Middle Name:R
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1860
Mailing Address - Fax:
Practice Address - Street 1:2001 S MERRIMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5540
Practice Address - Country:US
Practice Address - Phone:734-727-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11017007A207Q00000X
MI4301509414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine