Individual
GISLAINE TSEMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9201 W THOMAS RD, PHOENIX, AZ 85037-3332
(623) 327-7313
(623) 327-5437
Mailing address
PO BOX 708850, SANDY, UT 84070-8850
(866) 869-2395
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33889
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
975980
—
AZ
01
—
AZ0781010
BCBS
AZ
01
—
P003J6264
RR MEDICARE
AZ
Enumeration date
03/23/2006
Last updated
04/30/2008
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