MEDICARE: DR. CHARLES W. SELTZER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RB0002X	Obesity Medicine (Internal Medicine) Physician	MD437081	PA

General Provider Information

NPI Number	:	1043463250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES W. SELTZER MD

Provider Business Mailing Address
First Line	:	1429 WALNUT ST
Second Line	:	SUITE 1101
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3218
Country	:	US
Telephone Number	:	215-279-8376
Fax Number	:	215-933-5593

Provider Business Practice Location Address
First Line	:	1429 WALNUT ST
Second Line	:	SUITE 1101
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3218
Country	:	US
Telephone Number	:	215-279-8376
Fax Number	:	215-933-5593

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	12/01/2015

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