Basic Information
| Provider Information | |||||||||
| NPI: | 1770755480 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SELIG | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8945 RIDGE AVE | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191282036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154838558 | ||||||||
| FaxNumber: | 2154871270 | ||||||||
| Practice Location | |||||||||
| Address1: | 8945 RIDGE AVE | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191282036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154838558 | ||||||||
| FaxNumber: | 2154871270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2008 | ||||||||
| LastUpdateDate: | 04/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD433902 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | MD433902 | 01 | PA | STATE MEDICAL LICENSE | OTHER |