Provider Demographics
NPI:1982904850
Name:SELLERS, ALLISON SU (DPM)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:SU
Last Name:SELLERS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:SU
Other - Last Name:COIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:3747 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5309
Mailing Address - Country:US
Mailing Address - Phone:304-797-0190
Mailing Address - Fax:304-797-1187
Practice Address - Street 1:3747 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5309
Practice Address - Country:US
Practice Address - Phone:304-797-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10422213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery