Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 10959193-1205 | UT |
Y | 111NI0900X | Internist | 10959193-1205 | UT |
NPI | 1003348913 |
---|---|
Provider Name | Jeffrey B Sellman |
First Address | Boston, MA 02118-3549 |
Second Address | Boston, MA 02118-3549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2017 |
Last Update Date | 19/08/2021 |