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Individual
LARRY W SELLERS
Active
Individual
LARRY W SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21998
NE
207R00000X
Internal Medicine Physician
26971
IA
208M00000X
Hospitalist Physician
Primary
26971
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3053389
—
NE
01
—
33531
WELLMARK BCBS - M.M. PHYS
IA
01
—
35828
BCBSNE - SOUTH SIOUX
NE
05
—
4053389
—
IA
05
—
421283849-12
—
NE
05
—
421283849-46
—
IA
Enumeration date
05/06/2006
Last updated
10/19/2007
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