Provider Demographics
NPI:1194882282
Name:SEMANCIK, GREGORY JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOHN
Last Name:SEMANCIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4120 LAUREL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5392
Mailing Address - Country:US
Mailing Address - Phone:907-743-6944
Mailing Address - Fax:907-743-0694
Practice Address - Street 1:4120 LAUREL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5392
Practice Address - Country:US
Practice Address - Phone:907-743-6944
Practice Address - Fax:907-743-0694
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2013-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK70762080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD9892Medicaid