Healthcare Provider Details
I. General information
NPI: 1548353345
Provider Name (Legal Business Name): LEONARD H SELTZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1309 VEALE RD, SUITE 11
WILMINGTON DE
19810-4609
US
IV. Provider business mailing address
1309 VEALE RD SUITE 11
WILMINGTON DE
19810
US
V. Phone/Fax
- Phone: 302-798-8070
- Fax: 302-798-5902
- Phone: 302-229-8506
- Fax: 302-478-7716
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | C10000499 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 1989019189 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: