Provider Demographics
NPI:1649293390
Name:SELLERS, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:SELLERS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S RUTHERFORD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-5991
Mailing Address - Country:US
Mailing Address - Phone:615-575-3795
Mailing Address - Fax:877-719-4275
Practice Address - Street 1:1715 S RUTHERFORD BLVD STE A
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5991
Practice Address - Country:US
Practice Address - Phone:615-575-3795
Practice Address - Fax:877-719-4275
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000005Medicaid
TNQ00701294OtherRR MEDICARE
TNG69921Medicare UPIN
TN3726277Medicare ID - Type Unspecified