Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301503576 | MI |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 4301503576 | MI |
NPI | 1023334919 |
---|---|
Provider Name | Dr. Andrew Bennett Sewell |
First Address | Saint Clair Shores, MI 48081-1156 |
Second Address | Saint Clair Shores, MI 48081-1156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2010 |
Last Update Date | 10/12/2020 |