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NPI Code Detail

MEDICARE: SUZANNA ELIZABETH SELLARS DO

MEDICARE: SUZANNA ELIZABETH SELLARS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianOT019645PA
2208000000XPediatrics PhysicianOS023405PA

General Provider Information

NPI Number : 1457812737
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNA ELIZABETH SELLARS DO
Provider Business Mailing Address
First Line : 6800 N ELM TREE RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53217-3702
Country : US
Telephone Number : 414-412-3640
Fax Number :
Provider Business Practice Location Address
First Line : 3401 CIVIC CENTER BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4319
Country : US
Telephone Number : 215-590-3537
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2019
Last Update Date : 12/09/2025

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