Provider Demographics
NPI:1023334919
Name:SEWELL, ANDREW BENNETT (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BENNETT
Last Name:SEWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:21000 E 12 MILE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1156
Mailing Address - Country:US
Mailing Address - Phone:586-779-7610
Mailing Address - Fax:586-779-0031
Practice Address - Street 1:21000 E 12 MILE RD STE 111
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1156
Practice Address - Country:US
Practice Address - Phone:586-779-7610
Practice Address - Fax:586-779-0031
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2020-12-10
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Provider Licenses
StateLicense IDTaxonomies
MI4301503576207Y00000X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology