Vijayalakshmi Selvaraj, M.D. – Pediatrics Physician

Key facts

NPI: 1003854563
Entity type: Individual (NPI type 1)
Primary specialty: Pediatrics Physician 208000000X
License: MD028373E (GA)
Practice address: 851 Evans City Rd
Renfrew, PA 16053-9207
Phone: (724) 789-9950
Fax: (724) 789-9958
NPI assigned: Jun 4, 2006
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Vijayalakshmi Selvaraj MD Pediatrics Physician · Renfrew, PA · NPI 1447386214

NPD (past) PEDIATRICS

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
MD028373E	GA	MD	Pediatrics Physician

Practice roles

Organization	Specialty	Status	New patients
Vijayalakshmi Selvaraj MD	Pediatrics	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatrics Physician	208000000X	MD028373E	GA	Yes

Addresses

Primary practice location

851 Evans City Rd
Renfrew, PA 16053-9207

Mailing address

851 Evans City Rd
Renfrew, PA 16053-9207
Phone (724) 789-9950

Other identifiers

Identifier	Type	State	Issuer
0015452650004	Medicaid	PA

Other providers in Renfrew, PA

All providers in Renfrew, PA · Pediatrics Physician in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.