Provider Demographics
NPI:1124009618
Name:SEMLER, CHARLES ELWIN (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ELWIN
Last Name:SEMLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 8TH ST
Mailing Address - Street 2:
Mailing Address - City:STORY CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50248-1301
Mailing Address - Country:US
Mailing Address - Phone:515-733-5191
Mailing Address - Fax:515-733-5354
Practice Address - Street 1:705 8TH ST
Practice Address - Street 2:
Practice Address - City:STORY CITY
Practice Address - State:IA
Practice Address - Zip Code:50248-1301
Practice Address - Country:US
Practice Address - Phone:515-733-5191
Practice Address - Fax:515-733-5354
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2068999Medicaid
IAA54840Medicare UPIN
IA2068999Medicaid