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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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