Individual
DIANNA LYNN SELDOMRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2025 FRONTIS PLAZA BLVD, SUITE 100, WINSTON SALEM, NC 27103-5663
(336) 768-3240
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
00026710
AL
207W00000X
Ophthalmology Physician
Primary
2009-00087
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15162
BCBSNC
NC
05
—
PENDING
—
NC
Enumeration date
07/22/2005
Last updated
04/12/2013
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