MEDICARE: DR. MERRY ELLEN SEBELIK 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	207Y00000X	Otolaryngology Physician	31659	TN
2	207Y00000X	Otolaryngology Physician	ME97014	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00380951	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	56616	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1871599332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERRY ELLEN SEBELIK M.D.

Provider Business Mailing Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	SUITE 1135
City	:	ATLANTA
State	:	GA
Zip	:	30308-2212
Country	:	US
Telephone Number	:	404-727-9610
Fax Number	:	404-712-1540

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	SUITE 1135
City	:	ATLANTA
State	:	GA
Zip	:	30308-2212
Country	:	US
Telephone Number	:	404-727-9610
Fax Number	:	404-712-1540

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/07/2016

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Directions to “ DR. MERRY ELLEN SEBELIK M.D.” Practice Location

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