1144209420 NPI number — HASSAN B SEMAAN M.D.

Table of content: HASSAN B SEMAAN M.D. (NPI 1144209420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144209420 NPI number — HASSAN B SEMAAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEMAAN
Provider First Name:
HASSAN
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144209420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4132 ELIDA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIMA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45807-1548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-223-3325
Provider Business Mailing Address Fax Number:
419-222-7917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4132 ELIDA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45807-1548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-223-3325
Provider Business Practice Location Address Fax Number:
419-222-7917
Provider Enumeration Date:
01/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  35.077550 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4108585 , issued by the state of ( OH ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 2182294 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00173502 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: H18266 . This identifiers is of the category "MEDICARE UPIN".
  • Identifier: SE4108584 , issued by the state of ( OH ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 000000347017 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".