Provider Demographics
NPI:1215928932
Name:SEMINARA, STEPHANIE BETH (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BETH
Last Name:SEMINARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-8433
Mailing Address - Fax:617-726-5367
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:BHX 505
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-8433
Practice Address - Fax:617-726-5357
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA155008207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA754136OtherTUFTS HEALTH PLAN
MAJ18760OtherBCBS MA
MA3177467Medicaid
MA754136OtherTUFTS HEALTH PLAN
MAA23426Medicare ID - Type Unspecified