Provider Demographics
NPI:1336208792
Name:SEMAAN, ELIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIE
Middle Name:S
Last Name:SEMAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 STAFFORD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3513
Mailing Address - Country:US
Mailing Address - Phone:413-748-9378
Mailing Address - Fax:413-748-9387
Practice Address - Street 1:300 STAFFORD ST STE 210
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3513
Practice Address - Country:US
Practice Address - Phone:413-748-9378
Practice Address - Fax:413-748-9387
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230519208600000X, 2086S0129X
AZ47597208600000X, 2086S0129X
NH163272086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3104130Medicaid
MA110120894AMedicaid