Healthcare Provider Details

I. General information

NPI: 1912316100
Provider Name (Legal Business Name): WILLIAM SELIG CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 PEARL RD
MIDDLEBURG HEIGHTS OH
44130-6552
US

IV. Provider business mailing address

5818 QUEENS HWY
PARMA HEIGHTS OH
44130-1503
US

V. Phone/Fax

Practice location:
  • Phone: 216-957-9700
  • Fax:
Mailing address:
  • Phone: 412-720-7516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.16285-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: