Provider Demographics
NPI:1184789786
Name:SEMIENS, TAJJ R
Entity type:Individual
Prefix:
First Name:TAJJ
Middle Name:R
Last Name:SEMIENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 E WESLEY CHAPEL WAY
Mailing Address - Street 2:STE. 4
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3430
Mailing Address - Country:US
Mailing Address - Phone:770-323-2990
Mailing Address - Fax:
Practice Address - Street 1:2550 E WESLEY CHAPEL WAY
Practice Address - Street 2:STE. 4
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3430
Practice Address - Country:US
Practice Address - Phone:770-323-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies