Selph, Jacqueline Marie
Selph, Jacqueline Marie is an individual health care provider with primary practice located at 15 Market Center Dr Ste A , Flat Rock NC 28731-8529. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Selph, Jacqueline Marie can be contacted via phone (286) 978-1170.Contact Information
Primary practice address
15 Market Center Dr Ste A
Flat Rock NC 28731-8529
Phone: (286) 978-1170
Fax: (828) 698-4939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | D84894 | Maryland |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 2019-00922 | North Carolina |
Profile Details
| NPI number | 1609219039 |
|---|---|
| LBN Legal business name | Selph, Jacqueline Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 16th, 2013 |
| Last updated | Jul 17th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609219039 | NPPES |
| North Carolina | Other | 006815480 | UHC |
| North Carolina | Other | P02346770 | UHC |
| North Carolina | Other | 205L8 | UHC |
| North Carolina | Other | NN9352F459 | UHC |
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