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General NPI Number Information
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NPI Number | 1376747733
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Entity Type | Individual
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Provider Name | KRISTOPHER J SELKE DO
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Gender | Male
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 2845 GREENBRIER RD
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City | GREEN BAY
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State | WI
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Zip | 54311-6519
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Country | US
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Telephone | 920-288-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 W FOREST HOME AVE
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City | MILWAUKEE
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State | WI
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Zip | 53215-2843
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Country | US
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Telephone | 920-288-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101016361
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 19778-875
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 51010116361
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 51010116361
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 74659
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License Number State | WI
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