Provider Demographics
NPI:1003000530
Name:SEMONCHE, AMANDA MARIE (DO)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:SEMONCHE
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 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951
Mailing Address - Country:US
Mailing Address - Phone:215-536-7998
Mailing Address - Fax:
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951
Practice Address - Country:US
Practice Address - Phone:215-536-7998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014260207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS014260OtherMEDICAL LICENSE NUMBER