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General NPI Number Information
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NPI Number | 1962769760
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Entity Type | Individual
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Provider Name | ANAND SELVAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 530 BOGACHIEL WAY
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City | FORKS
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State | WA
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Zip | 98331
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Country | US
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Telephone | 360-374-6271
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 UNIVERSITY ST APT 1701
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City | SEATTLE
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State | WA
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Zip | 98101-3189
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Country | US
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Telephone | 610-348-0462
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 127708
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 57.02092
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 125630
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 55175
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD60824986
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License Number State | WA
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