Provider Demographics
NPI:1992778351
Name:SELTZER, HOWARD MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MICHAEL
Last Name:SELTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:H
Other - Middle Name:MICHAEL
Other - Last Name:SELTZER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:804 DUNLAWTON AVE
Mailing Address - Street 2:UNIT 101
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4931
Mailing Address - Country:US
Mailing Address - Phone:386-788-4644
Mailing Address - Fax:386-788-8497
Practice Address - Street 1:804 DUNLAWTON AVE
Practice Address - Street 2:UNIT 101
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4931
Practice Address - Country:US
Practice Address - Phone:386-788-4644
Practice Address - Fax:386-788-8497
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30839207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology