Seldera, Juanilito N

Seldera, Juanilito N is an individual health care provider with primary practice located at N2950 State Road 67 , Lake Geneva WI 53147-2655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Seldera, Juanilito N can be contacted via phone (262) 245-4990.

Contact Information

Primary practice address
N2950 State Road 67 Lake Geneva WI 53147-2655
Phone: (262) 245-4990
Fax: (262) 245-2248
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 23586-20 Wisconsin

Profile Details

NPI number 1750498945
LBN Legal business name Seldera, Juanilito N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750498945 NPPES
Wisconsin MEDICAID 30372400
Wisconsin MEDICAID 036061793 2
Wisconsin Other SELDEJUA
Wisconsin Other 1750498945
Wisconsin MEDICAID 1750498956

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