Individual
MICHAEL GRANT SELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 SKAGGS RD, STE 302, BRANSON, MO 65616-2062
(417) 334-8288
(417) 334-6966
Mailing address
101 SKAGGS RD STE 302, BRANSON, MO 65616-2062
(417) 334-8288
(417) 334-6966
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2014008959
MO
207RN0300X
Nephrology Physician
Primary
2014008959
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000014075
—
MO
05
—
212205001
—
AR
Enumeration date
11/06/2008
Last updated
07/08/2023
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