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NPI Code Detail

MEDICARE: SELVA GANESH, MD, PA

MEDICARE: SELVA GANESH, MD, PA
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
1174400000XSpecialistME0025890FL

Other Identifiers

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

General Provider Information

NPI Number : 1467605857
Entity Type Code : Organization
Provider Name (Legal Business Name) : SELVA GANESH, MD, PA
Provider Business Mailing Address
First Line : 211 E BOYNTON BEACH BLVD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-3839
Country : US
Telephone Number : 561-732-3200
Fax Number : 561-732-6849
Provider Business Practice Location Address
First Line : 211 E BOYNTON BEACH BLVD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-3839
Country : US
Telephone Number : 561-732-3200
Fax Number : 561-732-6849
Authorized Official
Title or Position : OWNER/DOCTOR
Name : DR. SELVA GANESH
Credential : M.D.
Telephone Number : 561-732-3200
Provider Enumeration Date : 10/29/2008
Last Update Date : 08/09/2011

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1982638839 — DR. NOEL LEE CHUN M.D.
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Directions to “SELVA GANESH, MD, PA ” Practice Location

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