Individual
DR. CHARLES PETER SANICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
372 MILL ST, HAGERSTOWN, MD 21740-6138
(301) 790-2270
(301) 790-2327
Mailing address
372 MILL ST, HAGERSTOWN, MD 21740-6138
(301) 790-2270
(301) 790-2327
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
470
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
368998100
—
MD
01
—
405775900
DME MEDICAID
MD
Enumeration date
07/04/2006
Last updated
08/12/2008
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