Individual
SELINA JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
340 MEDICAL PKWY STE 200, GREER, SC 29650-2441
(864) 797-9400
(864) 797-9402
Mailing address
300 E MCBEE AVE STE 300, GREENVILLE, SC 29601-2899
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
91169
SC
208600000X
Surgery Physician
MD484296
PA
2086S0102X
Surgical Critical Care Physician
MD484296
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16212644
CAQH
—
Enumeration date
06/08/2017
Last updated
09/02/2025
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