Provider Demographics
NPI:1871261594
Name:SEMMAWRIGHTPODIATRY PC
Entity Type:Organization
Organization Name:SEMMAWRIGHTPODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTELLE-SEMMA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-590-5414
Mailing Address - Street 1:25201 SHEARWATER CIR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-4244
Mailing Address - Country:US
Mailing Address - Phone:248-590-5414
Mailing Address - Fax:
Practice Address - Street 1:770 RIVERSIDE AVE STE 205
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1465
Practice Address - Country:US
Practice Address - Phone:517-280-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty