Provider Demographics
NPI:1770653966
Name:SEMENTI, MARY CATHERINE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CATHERINE
Last Name:SEMENTI
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:PO BOX 3990
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-6990
Mailing Address - Country:US
Mailing Address - Phone:808-240-0140
Mailing Address - Fax:808-245-4146
Practice Address - Street 1:4643-B WAIMEA CANYON DRIVE
Practice Address - Street 2:
Practice Address - City:WAIMEA
Practice Address - State:HI
Practice Address - Zip Code:96796
Practice Address - Country:US
Practice Address - Phone:808-240-0140
Practice Address - Fax:808-338-1606
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1038207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI555873 01Medicaid
HI0000247593OtherHMSA
HI343156OtherUHA
HI00A0247591OtherHMSA
HI565749OtherHMA
HI523979-01OtherMEDICAID FQHC
HI555873 01Medicaid
HI57250Medicare PIN
HI343156OtherUHA