Organization
SEMIRA CHARBONEAU INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEMIRA CHARBONEAU D.O. (PHYSICIAN)
(580) 332-4443
Entity
Organization
Contact information
Practice address
625 N MONTE VISTA ST, ADA, OK 74820-4613
(580) 332-4443
(580) 332-4846
Mailing address
625 N MONTE VISTA ST, ADA, OK 74820-4613
(580) 332-4443
(580) 332-4846
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00035275
RAILROAD MEDICARE
OK
Enumeration date
02/02/2007
Last updated
03/27/2008
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