Individual
DR. ILYA SELEZNEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(315) 768-8778
Mailing address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2025016160
MO
208M00000X
Hospitalist Physician
Primary
2025016160
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2022
Last updated
06/19/2025
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