Individual
BENSON SELITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5050 SCHAEFER RD, DEARBORN, MI 48126-3249
(313) 581-2600
(313) 581-0228
Mailing address
1182 STONECREST DR, BLOOMFIELD, MI 48302-2840
(248) 737-2669
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101005867
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027698
MIDWEST HEALTH PLAN
MI
05
—
114445728
—
MI
01
—
120191
GREAT LAKES HEALTH PLAN
MI
01
—
300Q264480
BCBSM/BCN
MI
01
—
57100
OMNICARE HEALTH PLAN
MI
01
—
5790032
AETNA
MI
Enumeration date
05/24/2006
Last updated
12/23/2011
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