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Organization

TANYA R. SELLERS-HANNIBAL, DPM, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANYA R SELLERS-HANNIBAL DPM (OWNER)
(410) 581-8331
Entity
Organization

Contact information

Practice address
10085 RED RUN BLVD, SUITE 305, OWINGS MILLS, MD 21117-4836
(410) 581-8331
(410) 581-8332
Mailing address
10085 RED RUN BLVD, SUITE 305, OWINGS MILLS, MD 21117-4836
(410) 581-8331
(410) 581-8332

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
01173
MD
213E00000X
Podiatrist
PO543
DC
213ES0131X
Foot Surgery Podiatrist
Primary
01173
MD
213ES0131X
Foot Surgery Podiatrist
PO543
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119128400
MD
Enumeration date
03/16/2010
Last updated
03/17/2010
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