Provider Demographics
NPI:1366550071
Name:SIMMEN, ROBERT W (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:SIMMEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5476 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044
Mailing Address - Country:US
Mailing Address - Phone:724-444-6644
Mailing Address - Fax:724-444-6671
Practice Address - Street 1:5476 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044
Practice Address - Country:US
Practice Address - Phone:724-444-6644
Practice Address - Fax:724-444-6671
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3071111N00000X
PADC009400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1700465OtherBCBS
PA412158OtherUPMC
SC156877Medicaid
PA6453617OtherCIGNA
PA1700465OtherBCBS
PA412158OtherUPMC