MEDICARE: DR. TIMOTHY L. SELL M.D.

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
1	174400000X	Specialist		MI
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	4301063521	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699745232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY L. SELL M.D.

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 3D
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22060 BEECH ST STE 300
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2847
Country	:	US
Telephone Number	:	313-228-0230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	07/19/2022

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