Healthcare Provider Details

I. General information

NPI: 1528225356
Provider Name (Legal Business Name): MATTHEW B SELLERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 INNOVATION DR. STE. 400
GREENVILLE SC
29607-5270
US

IV. Provider business mailing address

PO BOX 743294
ATLANTA GA
30374-3294
US

V. Phone/Fax

Practice location:
  • Phone: 864-235-7665
  • Fax: 864-233-5971
Mailing address:
  • Phone: 864-235-7665
  • Fax: 864-233-5971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number38456
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number38456
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: