Provider Demographics
NPI:1770043523
Name:SELWYN, JULIA CHRISTINE (DO)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:CHRISTINE
Last Name:SELWYN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:CHRISTINE
Other - Last Name:ANDRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-5250
Mailing Address - Fax:601-984-5283
Practice Address - Street 1:500 UNIVERSITY DR # C-1630
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-1368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
MS316202080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program