Provider Demographics
NPI:1528225356
Name:SELLERS, MATTHEW B (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:B
Last Name:SELLERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 743294
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3294
Mailing Address - Country:US
Mailing Address - Phone:864-235-7665
Mailing Address - Fax:864-233-5971
Practice Address - Street 1:2 INNOVATION DR.
Practice Address - Street 2:STE. 400
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5270
Practice Address - Country:US
Practice Address - Phone:864-235-7665
Practice Address - Fax:864-233-5971
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2016-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC38456207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC384569Medicaid
SC384569Medicaid
SCSC65417111Medicare UPIN