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Individual

TANYA R SELLERS-HANNIBAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

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
Primary
01173
MD
213ES0131X
Foot Surgery Podiatrist
01173
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119128400
MD
01
T366
BCBS
MD
Enumeration date
07/21/2005
Last updated
07/25/2017
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