Individual
DR. JUANILITO N SELDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4990
(262) 245-2248
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4990
(262) 245-2248
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23586-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061793 2
—
IL
01
—
1750498945
BCBSWI
WI
05
—
1750498956
—
WI
05
—
30372400
—
WI
01
—
SELDEJUA
MERCYCARE INSURANCE
WI
Enumeration date
08/24/2006
Last updated
03/07/2023
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