Provider Demographics
NPI:1427195759
Name:SELLERS, CHRISTOPHER WADE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WADE
Last Name:SELLERS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 REDMOND CIR NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1307
Mailing Address - Country:US
Mailing Address - Phone:706-295-6704
Mailing Address - Fax:706-802-5681
Practice Address - Street 1:1309 REDMOND CIR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1307
Practice Address - Country:US
Practice Address - Phone:706-295-6704
Practice Address - Fax:706-802-5681
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025271208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD42142Medicare UPIN