Provider Demographics
NPI:1841463445
Name:SEWELL, MICHAEL J (RNFA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SEWELL
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79105
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30357-7105
Mailing Address - Country:US
Mailing Address - Phone:404-872-8799
Mailing Address - Fax:404-874-3544
Practice Address - Street 1:95 COLLIER RD NW
Practice Address - Street 2:STE 4025
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1796
Practice Address - Country:US
Practice Address - Phone:404-872-8799
Practice Address - Fax:404-874-3544
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN194952163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant