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Individual

CHARLES G SEWALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 OAK RIDGE TPKE, SUITE C-100, OAK RIDGE, TN 37830-6957
(865) 483-2288
(865) 482-4400
Mailing address
800 OAK RIDGE TPKE, SUITE C-100, OAK RIDGE, TN 37830-6957
(865) 483-2288
(865) 482-4400

Taxonomy

Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
021441
TN
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
28475
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000252844
ANTHEM BLUE CROSS
KY
01
100020676
PHP TENNCARE
TN
01
3028800
BLUE CROSS BLUE SHIELD
TN
05
3059927
TN
01
4532
CHA
KY
01
4666257
AETNA
TN
01
620897289002
BLUEGRASS
KY
01
62089728903
UHC RIVER VALLEY
TN
05
64799125
KY
01
C10003
CUMBERLAND HEALTHCARE
KY
Enumeration date
08/28/2005
Last updated
05/17/2023
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