Healthcare Provider Details

I. General information

NPI: 1649658303
Provider Name (Legal Business Name): CHRISTOPHER NEIL SELLECK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N COVE BLVD FL 1
TOLEDO OH
43606-3895
US

IV. Provider business mailing address

2142 N COVE BLVD FL 1
TOLEDO OH
43606-3895
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-1111
  • Fax: 419-479-3253
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME134765
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.157023
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: