Provider Demographics
NPI:1649318668
Name:SELL, STEPHEN MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:SELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6448
Mailing Address - Country:US
Mailing Address - Phone:215-942-2626
Mailing Address - Fax:215-942-2628
Practice Address - Street 1:229 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6448
Practice Address - Country:US
Practice Address - Phone:215-942-2626
Practice Address - Fax:215-942-2628
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASE1796406OtherHIGHMARK BLUE SHIELD
PA097236Medicare ID - Type Unspecified
PASE1796406OtherHIGHMARK BLUE SHIELD