Provider Demographics
NPI:1225042468
Name:SEMINE, SAMIR N (MD)
Entity Type:Individual
Prefix:
First Name:SAMIR
Middle Name:N
Last Name:SEMINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-0688
Mailing Address - Country:US
Mailing Address - Phone:781-762-8010
Mailing Address - Fax:781-762-7753
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 215
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-762-5595
Practice Address - Fax:781-762-9966
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA559592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3005313Medicaid
MA24100OtherHARVARD PILGRIM
MAJ05699OtherBLUE SHIELD
MA055959OtherTUFTS HEALTH PLAN
MAJ05699Medicare ID - Type Unspecified
MA055959OtherTUFTS HEALTH PLAN