Provider Demographics
NPI:1538188339
Name:SELLERS, CRAIG S (DPM)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:S
Last Name:SELLERS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 WESTERN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-423-9113
Mailing Address - Fax:419-423-8377
Practice Address - Street 1:1733 WESTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-423-9113
Practice Address - Fax:419-423-8377
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-002855213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000139909OtherANTHEMBCBS
OH0147335Medicaid
OH0147335Medicaid
OHU58503Medicare UPIN
OH480020912Medicare PIN