Provider Demographics
NPI:1548084817
Name:SEMAAN, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SEMAAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 YOSEMITE BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5202
Mailing Address - Country:US
Mailing Address - Phone:248-688-7588
Mailing Address - Fax:
Practice Address - Street 1:4050 W MAPLE RD STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3118
Practice Address - Country:US
Practice Address - Phone:248-885-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant