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General NPI Number Information
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NPI Number | 1083689152
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Entity Type | Individual
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Provider Name | JOHN CALVERT SEWELL MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 609 DAFFIN LN
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City | DENTON
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State | MD
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Zip | 21629
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Country | US
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Telephone | 410-479-2650
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Fax | 410-479-1626
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Provider Business Mailing Address
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Address Line | PO BOX 660
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City | DENTON
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State | MD
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Zip | 21629
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Country | US
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Telephone | 410-479-4306
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Fax | 410-479-1714
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0011634
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License Number State | MD
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