Provider Demographics
NPI:1053537308
Name:ROBERT D. SEMLOW D.C, P.C
Entity type:Organization
Organization Name:ROBERT D. SEMLOW D.C, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:SEMLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-879-8144
Mailing Address - Street 1:6780 ROCESTER RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1243
Mailing Address - Country:US
Mailing Address - Phone:248-879-8144
Mailing Address - Fax:248-879-8813
Practice Address - Street 1:6780 ROCESTER RD.
Practice Address - Street 2:SUITE A
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1243
Practice Address - Country:US
Practice Address - Phone:248-879-8144
Practice Address - Fax:248-879-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS004062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P23470OtherMEDICARE ADVANTAGE
MI0P23470OtherMEDICARE PLUS BLUE
MIT97296OtherHEALTH ALLIANCE PLAN
MIT97296OtherHEALTH ALLIANCE PLAN
MIT97296Medicare UPIN