Provider Demographics
NPI:1386933125
Name:SEMMA, RANDY (DPM)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:SEMMA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WELCH RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-2864
Mailing Address - Country:US
Mailing Address - Phone:248-956-0177
Mailing Address - Fax:248-694-2102
Practice Address - Street 1:1001 WELCH RD
Practice Address - Street 2:SUITE 110
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48390-2864
Practice Address - Country:US
Practice Address - Phone:248-056-0177
Practice Address - Fax:248-694-2102
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2015-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3617213ES0103X
MI5901002563213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery