Individual
PETER C SELINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
428 COUNTY LINE ROAD, WESTERVILLE, OH 43082
(614) 847-4100
(614) 430-1601
Mailing address
428 COUNTY LINE ROAD, WESTERVILLE, OH 43082
(614) 847-4100
(614) 430-1601
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35077832
OH
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
35077832
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000309770
ANTHEM
OH
05
—
2192676
—
OH
01
—
P00095225
RR MEDICARE
OH
Enumeration date
12/09/2005
Last updated
08/13/2020
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