Provider Demographics
NPI:1952363152
Name:PICKER, SELWYN (MD)
Entity Type:Individual
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First Name:SELWYN
Middle Name:
Last Name:PICKER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 310A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-6267
Mailing Address - Fax:314-251-5871
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 310A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-6267
Practice Address - Fax:314-251-5871
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2019-01-10
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Provider Licenses
StateLicense IDTaxonomies
MO36202207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO131961OtherHEALTHLINK
MO34211OtherGROUP HEALTH PLAN
MO0600012OtherUNITED HEALTHCARE
MO3175711001OtherCIGNA
MO140003858OtherRAILROAD MEDICARE
MO25715OtherBLUE CROSS BLUE SHIELD