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General NPI Number Information
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NPI Number | 1376869610
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Entity Type | Individual
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Provider Name | COURTNEY MICHELLE SELBERG M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2010
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4787
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Fax | 513-636-3928
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE # MLC2017
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4787
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Fax | 513-636-3928
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | DR.0055302
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 35.152481
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DR.0055302
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ML60164018
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License Number State | WA
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