Individual
DR. SHANON MARK SELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1401 13TH AVE E, WEST FARGO, ND 58078-3468
(701) 364-5751
(701) 364-5722
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-5751
(701) 364-5722
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41077
MN
207Q00000X
Family Medicine Physician
Primary
6693
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812913400
—
MN
Enumeration date
07/19/2006
Last updated
12/29/2015
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