MEDICARE: SHARLENE SELVARATNAM 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	232570	MA
2	207Q00000X	Family Medicine Physician	Q7467	TX

General Provider Information

NPI Number	:	1972703957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARLENE SELVARATNAM M.D.

Provider Business Mailing Address
First Line	:	2008 E HEBRON PKWY STE 114
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-1601
Country	:	US
Telephone Number	:	206-409-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 E HEBRON PKWY STE 114
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-1601
Country	:	US
Telephone Number	:	469-431-0544
Fax Number	:

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

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	06/29/2024

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