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DR. VICTOR THIAGARAJ SELVARAJ M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1356436901

Individual Registrant:
DR. VICTOR THIAGARAJ SELVARAJ M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
549 NW KALE WHITNEY PLACE SUITE 104-105 PORT ST. LUCIE, FL 34986 US
Tel: 772-621-9993  Fax: 772-621-9923

Contact information for business:
549 NW LAKE WHITNEY PLACE SUITE 106 PORT ST. LUCIE, FL 34986 US
Tel: 772-621-9993  Fax: 772-621-9923

Registration Information:
NPI: 1356436901
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
FLME29947

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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