Provider Demographics
NPI:1255377586
Name:SELDEN, STEVEN E (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:SELDEN
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 1:510 COTTAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3123
Mailing Address - Country:US
Mailing Address - Phone:860-243-1414
Mailing Address - Fax:860-286-0510
Practice Address - Street 1:510 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3123
Practice Address - Country:US
Practice Address - Phone:860-243-1414
Practice Address - Fax:860-286-0510
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT21134207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001211341Medicaid
0384440001OtherDMERC
CT200025714OtherRAILROAD MEDICARE
0384440001OtherDMERC
CT001211341Medicaid