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General NPI Number Information
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NPI Number | 1508841875
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Entity Type | Organization
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Legal Business Name | KENNETH G SELKE MD
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 224 S WOODS MILL RD STE. 670 SOUTH
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3451
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Country | US
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Telephone | 314-469-2182
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Fax | 314-469-5725
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Provider Business Mailing Address
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Address Line | 224 S WOODS MILL RD STE. 670 SOUTH
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3451
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Country | US
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Telephone | 314-469-2182
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Fax | 314-469-5725
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH G SELKE
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Credential | MD
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Telephone | 314-469-2182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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