Provider Demographics
NPI:1447212824
Name:SEMLOW, ROBERT DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DONALD
Last Name:SEMLOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1243
Mailing Address - Country:US
Mailing Address - Phone:248-879-8144
Mailing Address - Fax:248-879-8813
Practice Address - Street 1:6780 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1243
Practice Address - Country:US
Practice Address - Phone:248-879-8144
Practice Address - Fax:248-879-8813
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS004062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT97296OtherHEALTH ALLIANCE PLAN
MI950F32884OtherBLUE CROSS
MIP23470001Medicare PIN
MI950F32884OtherBLUE CROSS
T97296Medicare UPIN