Provider Demographics
NPI:1134274087
Name:SELLERS, RANDY P (MD)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:P
Last Name:SELLERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2231
Mailing Address - Country:US
Mailing Address - Phone:919-493-6600
Mailing Address - Fax:919-493-5577
Practice Address - Street 1:211 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-493-6600
Practice Address - Fax:919-493-5577
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94013312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1053038OtherCIGNA PROVIDER NUMBER
NC1073AOtherBCBS PROVIDER I.D.
NCG07996Medicare UPIN