Individual
SEMRA OLGAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
218991
NY
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
MD00046810
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4364OL
BLUE SHIELD #
WA
05
—
8469736
—
WA
01
—
P00393463
RAILROAD MC #
WA
01
—
US7434599
AETNA PCP PIN
WA
Enumeration date
01/18/2006
Last updated
04/14/2015
Update your record
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