Provider Demographics
NPI:1316092141
Name:SELLAND, CAROL H (CRNA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:H
Last Name:SELLAND
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 WHITCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3347
Mailing Address - Country:US
Mailing Address - Phone:781-749-4914
Mailing Address - Fax:
Practice Address - Street 1:696 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1842
Practice Address - Country:US
Practice Address - Phone:781-331-3820
Practice Address - Fax:781-331-1076
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA83399207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA0097Medicare ID - Type Unspecified