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NPI Code Detail

MEDICARE: MR. DAVID ROBERT SELDEN MSW

MEDICARE: MR. DAVID ROBERT SELDEN MSW
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
11041C0700XClinical Social Worker104496MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S019325OTHERMACHAMPUS

General Provider Information

NPI Number : 1982705729
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID ROBERT SELDEN MSW
Provider Business Mailing Address
First Line : 2 ALBA AVE
Second Line :
City : SALEM
State : MA
Zip : 01970-1201
Country : US
Telephone Number : 978-745-8123
Fax Number :
Provider Business Practice Location Address
First Line : 301 BROADWAY
Second Line :
City : CHELSEA
State : MA
Zip : 02150-2807
Country : US
Telephone Number : 617-912-7985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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Directions to “ MR. DAVID ROBERT SELDEN MSW” Practice Location

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