Provider Demographics
NPI:1639349897
Name:SEMIAN SURGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:SEMIAN SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SEMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-374-9339
Mailing Address - Street 1:ONE COMMERCE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870
Mailing Address - Country:US
Mailing Address - Phone:570-374-9339
Mailing Address - Fax:570-374-7436
Practice Address - Street 1:ONE COMMERCE AVENUE
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870
Practice Address - Country:US
Practice Address - Phone:570-374-9339
Practice Address - Fax:570-374-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD418609261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA128095OtherMEDICARE PTAN