Provider Demographics
NPI:1306478763
Name:SALEM RHEUMATOLOGY PA
Entity type:Organization
Organization Name:SALEM RHEUMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-659-4585
Mailing Address - Street 1:751 BETHESDA RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3300
Mailing Address - Country:US
Mailing Address - Phone:336-659-4585
Mailing Address - Fax:336-659-4548
Practice Address - Street 1:751 BETHESDA RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3300
Practice Address - Country:US
Practice Address - Phone:336-659-4585
Practice Address - Fax:336-659-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty