Individual
DR. RANDALL E SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4411 THE 25 WAY NE, SUITE 150, ALBUQUERQUE, NM 87109-5857
(505) 332-6900
(505) 332-6921
Mailing address
4411 THE 25 WAY NE, SUITE 150, ALBUQUERQUE, NM 87109-5857
(505) 332-6900
(505) 332-6921
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD 019240
LA
2085R0202X
Diagnostic Radiology Physician
Primary
MD2013-0672
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00113321
—
MS
05
—
1962945
—
LA
01
—
300054356
RR MEDICARE
—
05
—
46678735
—
NM
Enumeration date
11/02/2005
Last updated
03/13/2014
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