Provider Demographics
NPI:1780861864
Name:SELHORST, CHRISTOPHER C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:C
Last Name:SELHORST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-8100
Mailing Address - Country:US
Mailing Address - Phone:202-853-2174
Mailing Address - Fax:
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:510-292-1478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA884502085R0202X
MAPENDING2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty