MEDICARE: ROBERT E SELBY 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	207N00000X	Dermatology Physician	12716	AZ

General Provider Information

NPI Number	:	1346399284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E SELBY M.D.

Provider Business Mailing Address
First Line	:	4280 N CAMPBELL AVE
Second Line	:	SUITE 212
City	:	TUCSON
State	:	AZ
Zip	:	85718-6585
Country	:	US
Telephone Number	:	520-529-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	4280 N CAMPBELL AVE
Second Line	:	SUITE 212
City	:	TUCSON
State	:	AZ
Zip	:	85718-6585
Country	:	US
Telephone Number	:	520-529-2775
Fax Number	:

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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Directions to “ ROBERT E SELBY M.D.” Practice Location

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