Provider Demographics
NPI:1821088238
Name:SELTER, LAWRENCE FRANKLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:FRANKLIN
Last Name:SELTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-5600
Mailing Address - Fax:617-726-7541
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 6900
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2724
Practice Address - Fax:617-726-7541
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA34843208000000X, 2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA724834OtherTUFTS HEALTH PLAN
MA0110582Medicaid
MAB33546OtherBCBS MA
MAB33546OtherBCBS MA
A35812Medicare UPIN