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Organization

KENNETH G SELKE MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH G SELKE MD (PRESIDENT)
(314) 469-2182
Entity
Organization

Contact information

Practice address
224 S WOODS MILL RD, STE. 670 SOUTH, CHESTERFIELD, MO 63017-3451
(314) 469-2182
(314) 469-5725
Mailing address
224 S WOODS MILL RD, STE. 670 SOUTH, CHESTERFIELD, MO 63017-3451
(314) 469-2182
(314) 469-5725

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110037903
RAILROAD MEDICARE
01
C4134
RAILROAD MEDICARE
Enumeration date
12/09/2005
Last updated
04/24/2013
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