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General NPI Number Information
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NPI Number | 1982118592
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Entity Type | Individual
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Provider Name | MICHAEL SORRELL APRN
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Gender | Male
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2475 BROAD ST
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City | SUMTER
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State | SC
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Zip | 29150-1820
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Country | US
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Telephone | 803-778-6555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749306
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City | ATLANTA
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State | GA
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Zip | 30374-9306
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Country | US
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Telephone | 843-238-1461
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Fax | 843-828-0622
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 21389
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21389
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License Number State | SC
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