Provider Demographics
NPI:1174688543
Name:SEMELKA, MELANIE BETH (DO)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:BETH
Last Name:SEMELKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5927 STATE ROUTE 981
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2687
Mailing Address - Country:US
Mailing Address - Phone:724-537-2131
Mailing Address - Fax:
Practice Address - Street 1:5927 STATE ROUTE 981
Practice Address - Street 2:SUITE 8
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2687
Practice Address - Country:US
Practice Address - Phone:724-537-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 012454208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics