Selo, Richard A

Selo, Richard A is an individual health care provider with primary practice located at 1345 Unity Pl Suite 110, Lafayette IN 47905-5768. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Selo, Richard A can be contacted via phone (765) 447-9308.

Contact Information

Primary practice address
1345 Unity Pl Suite 110 Lafayette IN 47905-5768
Phone: (765) 447-9308
Fax: (765) 447-2387
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 01035858A Indiana

Profile Details

NPI number 1588633952
LBN Legal business name Selo, Richard A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Mar 23rd, 2012 - about 14 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 1588633952 NPPES
Indiana Other 000000110557 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 100473320 ANTHEM PROVIDER NUMBER

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