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NPI Code Detail

MEDICARE: MR. ANDREW SELIG PA-C

MEDICARE: MR. ANDREW SELIG PA-C
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
1363A00000XPhysician AssistantPA9107633FL
2363AM0700XMedical Physician AssistantPA9107633FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336579374
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW SELIG PA-C
Provider Business Mailing Address
First Line : 1673 MASON AVE STE 305
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32117-5516
Country : US
Telephone Number : 386-274-7118
Fax Number : 386-274-6173
Provider Business Practice Location Address
First Line : 1673 MASON AVE STE 305
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32117-5516
Country : US
Telephone Number : 386-274-7118
Fax Number : 386-274-6173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2013
Last Update Date : 10/19/2018

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Directions to “ MR. ANDREW SELIG PA-C” Practice Location

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