Individual
DR. SEMIRA CHARBONEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
905 COLONY DR, ADA, OK 74820-2329
(580) 436-5111
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4038
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200011300A
—
OK
01
—
P00035275
RAILDROAD MEDICARE
OK
Enumeration date
07/12/2005
Last updated
02/22/2023
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