Healthcare Provider Details

I. General information

NPI: 1508063660
Provider Name (Legal Business Name): CURTIS TRIGUEIRO SELSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20333 W 151ST ST
OLATHE KS
66061-5350
US

IV. Provider business mailing address

5800 FOXRIDGE DR STE 240
MISSION KS
66202-2347
US

V. Phone/Fax

Practice location:
  • Phone: 913-791-4291
  • Fax:
Mailing address:
  • Phone: 913-362-5434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2013006633
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number04-36379
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5625
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: