Healthcare Provider Details

I. General information

NPI: 1639858194
Provider Name (Legal Business Name): MICHAEL SELLARS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 GENESEE ST
AUBURN NY
13021-3257
US

IV. Provider business mailing address

163 VETERANS DR
WHITE RIVER JUNCTION VT
05009-0001
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-5622
  • Fax:
Mailing address:
  • Phone: 802-295-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number030.0133991
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberORT011092
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: