Provider Demographics
NPI:1720048788
Name:SELTZER, BARRY R (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:R
Last Name:SELTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:4515 PREMIER DR
Practice Address - Street 2:STE 204
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8357
Practice Address - Country:US
Practice Address - Phone:336-802-2075
Practice Address - Fax:336-802-2076
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC93-00311207RG0300X
NC9300311207RG0300X, 204R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC9765AMedicaid
NC897519AMedicaid
NC897519AMedicaid
NCNC9765AMedicare PIN
NC2189147Medicare ID - Type Unspecified