Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | OS014260 | PA |
Y | 111NI0900X | Internist | OS014260 | PA |
NPI | 1003000530 |
---|---|
Provider Name | Amanda Marie Semonche |
First Address | Quakertown, PA 18951 |
Second Address | Quakertown, PA 18951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 14/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OS014260 | MEDICAL LICENSE NUMBER (01) | PA |