Provider Demographics
NPI:1972581734
Name:SELIP, STEVEN W (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:SELIP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:520 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-8060
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:911 LIGONIER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1805
Practice Address - Country:US
Practice Address - Phone:724-537-8518
Practice Address - Fax:724-537-6613
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039198L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009654250003Medicaid
PA451279Medicare PIN
PA0009654250003Medicaid