MEDICARE: DR. LEONID SELYA MD PHD

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	207X00000X	Orthopaedic Surgery Physician	D0055085	MD

Other Identifiers

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

General Provider Information

NPI Number	:	1386639755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID SELYA MD PHD

Provider Business Mailing Address
First Line	:	7404 EXECUTIVE PL STE 350
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-6268
Country	:	US
Telephone Number	:	301-599-9500
Fax Number	:	240-542-2959

Provider Business Practice Location Address
First Line	:	8116 GOOD LUCK RD STE 200
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-3508
Country	:	US
Telephone Number	:	301-599-9500
Fax Number	:	301-552-7483

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	08/19/2019

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