MEDICARE: DR. STEPHEN M SELTZER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	6191	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073555231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M SELTZER M.D.

Provider Business Mailing Address
First Line	:	6367 E TANQUE VERDE RD
Second Line	:	STE. 200
City	:	TUCSON
State	:	AZ
Zip	:	85715-3829
Country	:	US
Telephone Number	:	520-290-5888
Fax Number	:	520-290-5551

Provider Business Practice Location Address
First Line	:	6367 E TANQUE VERDE RD
Second Line	:	STE. 200
City	:	TUCSON
State	:	AZ
Zip	:	85715-3829
Country	:	US
Telephone Number	:	520-290-5888
Fax Number	:	520-290-5551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	10/22/2007

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