Provider Demographics
NPI:1548353345
Name:SELTZER, LEONARD H (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:H
Last Name:SELTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 VEALE RD SUITE 11
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-229-8506
Mailing Address - Fax:302-478-7716
Practice Address - Street 1:1309 VEALE RD, SUITE 11
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4609
Practice Address - Country:US
Practice Address - Phone:302-798-8070
Practice Address - Fax:302-798-5902
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10000499207K00000X
DE1989019189207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000104001Medicaid
4290062OtherAETNA
0081591000OtherKEYSTONE
G02212M02Medicare ID - Type Unspecified
4290062OtherAETNA
DE0000104001Medicaid