Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 4301071436 | MI |
N | 207ND0101X | MOHS-Micrographic Surgeon | 4301071436 | MI |
N | 207NS0135X | Procedural Dermatology | 4301071436 | MI |
NPI | 1063470078 |
---|---|
Provider Name | David Charles Semler |
First Address | Portage, MI 49024-4883 |
Second Address | Portage, MI 49024-4883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 16/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3465000 | (05) | MI |
G68036 | (02) | MI |