Provider Demographics
NPI:1841393469
Name:SHEMO, ANN M (DO)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:SHEMO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:SARPEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10058 S MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH MOUNTAIN
Mailing Address - State:PA
Mailing Address - Zip Code:17261-0900
Mailing Address - Country:US
Mailing Address - Phone:717-749-4002
Mailing Address - Fax:717-749-4071
Practice Address - Street 1:10058 S MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SOUTH MOUNTAIN
Practice Address - State:PA
Practice Address - Zip Code:17261-0900
Practice Address - Country:US
Practice Address - Phone:717-749-4002
Practice Address - Fax:717-749-4071
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S004085L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00251351Medicare PIN
PAE63969Medicare UPIN
PA161727Medicare PIN