Provider Demographics
NPI:1679599542
Name:SELMAN, WARREN R (MD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:R
Last Name:SELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NW 13TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-955-6663
Mailing Address - Fax:561-955-2879
Practice Address - Street 1:800 MEADOWS RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2304
Practice Address - Country:US
Practice Address - Phone:561-955-4600
Practice Address - Fax:833-625-1604
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-042211207T00000X
FLME163832207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH140003954OtherRAILROAD MEDICARE
OH743393OtherBUCKEYE MEDICAID
OH000000523191OtherANTHEM
PA1022614010001Medicaid
OH363999OtherWELLCARE MEDICAID
OH000000130224OtherANTHEM
OH0560987Medicaid
OH000000221215OtherUNISON
OH4007895OtherAETNA
OHP00428936OtherRAILROAD MEDICARE
PA1022614010001Medicaid
OH140003954OtherRAILROAD MEDICARE
OH363999OtherWELLCARE MEDICAID