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NPI Code Detail

MEDICARE: DR. MERRY ELLEN SEBELIK M.D.

MEDICARE:  DR. MERRY ELLEN SEBELIK  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician31659TN
2207Y00000XOtolaryngology PhysicianME97014FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00380951OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
256616OTHERFLBCBS

General Provider Information

NPI Number : 1871599332
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MERRY ELLEN SEBELIK M.D.
Provider Business Mailing Address
First Line : 550 PEACHTREE ST NE
Second Line : SUITE 1135
City : ATLANTA
State : GA
Zip : 30308-2212
Country : US
Telephone Number : 404-727-9610
Fax Number : 404-712-1540
Provider Business Practice Location Address
First Line : 550 PEACHTREE ST NE
Second Line : SUITE 1135
City : ATLANTA
State : GA
Zip : 30308-2212
Country : US
Telephone Number : 404-727-9610
Fax Number : 404-712-1540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 08/07/2016

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