Provider Demographics
NPI:1649485616
Name:SELTZER, WILLIAM KENT (PHD, FACMG)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KENT
Last Name:SELTZER
Suffix:
Gender:M
Credentials:PHD, FACMG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 W 3RD AVE
Mailing Address - Street 2:APT. 305
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1561
Mailing Address - Country:US
Mailing Address - Phone:508-277-7547
Mailing Address - Fax:
Practice Address - Street 1:111 W 3RD AVE
Practice Address - Street 2:APT. 305
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1561
Practice Address - Country:US
Practice Address - Phone:508-277-7547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYSELTW1170100000X
NJ25MS00007900170100000X
MT1052CLS170100000X
CADRN00000038170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics