MEDICARE: CHRISTOPHER SAMUEL SEWELL 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	207Q00000X	Family Medicine Physician	MD0000028362	TN

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	:	1881699981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER SAMUEL SEWELL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1320
Second Line	:
City	:	JAMESTOWN
State	:	TN
Zip	:	38556-1320
Country	:	US
Telephone Number	:	931-879-9892
Fax Number	:	931-879-9893

Provider Business Practice Location Address
First Line	:	341 W CENTRAL AVE
Second Line	:
City	:	JAMESTOWN
State	:	TN
Zip	:	38556-3405
Country	:	US
Telephone Number	:	931-879-9892
Fax Number	:	931-879-9893

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	12/11/2009

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