Healthcare Provider Details

I. General information

NPI: 1700836145
Provider Name (Legal Business Name): CHARLES WHITAKER SEWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE EMORY UNIVERSITY HOSPITAL, STE. H185C
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

1364 CLIFTON RD NE EMORY UNIVERSITY HOSPITAL, STE. H185C
ATLANTA GA
30322-1059
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-7003
  • Fax: 404-727-2519
Mailing address:
  • Phone: 404-712-7003
  • Fax: 404-727-2519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number013239
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number013239
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: