Provider Demographics
NPI:1033163951
Name:MICHAEL SELLMAN, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL SELLMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-347-1891
Mailing Address - Street 1:6701 N CHARLES ST
Mailing Address - Street 2:SUITE 1650
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6808
Mailing Address - Country:US
Mailing Address - Phone:410-347-1891
Mailing Address - Fax:
Practice Address - Street 1:301 SAINT PAUL ST
Practice Address - Street 2:POB 402
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-347-1891
Practice Address - Fax:410-347-1893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD721502900Medicaid
MD202MMedicare ID - Type Unspecified