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General NPI Number Information
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NPI Number | 1659443638
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Entity Type | Organization
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Legal Business Name | RICHARD SELLMAN MD PC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 601 W SPRUCE ST STE K
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City | MISSOULA
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State | MT
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Zip | 59802-4057
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Country | US
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Telephone | 406-543-0550
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Fax | 406-543-6180
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Provider Business Mailing Address
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Address Line | PO BOX 1656
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City | MISSOULA
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State | MT
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Zip | 59806-1656
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Country | US
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Telephone | 406-543-0550
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Fax | 406-543-6180
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Authorized Official
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Title or Position | OWNER OF CORPORATION
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Name | DR. RICHARD LAWRENCE SELLMAN JR.
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Credential | M.D.
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Telephone | 406-543-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 8613
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License Number State | MT
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