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Individual

DR. SELAM BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
400 ATHLETIC CLUB BLVD UNIT 101, CLAYTON, NC 27527-6558
(919) 267-1499
Mailing address
4109 WAKE FOREST RD STE 300, RALEIGH, NC 27609-2508
(919) 250-3478
(919) 250-6272

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200201084
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5905271
NC
Enumeration date
10/05/2006
Last updated
02/13/2026
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