Provider Demographics
NPI:1992238828
Name:SEMELKA, CHARLES THOMAS ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:THOMAS ALEXANDER
Last Name:SEMELKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INTERNAL MEDICINE RESIDENCY WF SCHOOL OF
Mailing Address - Street 2:MEDICAL CENTER BLVD, WATLINGTON HALL, 3RD FLOOR
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-4305
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-713-8250
Practice Address - Fax:336-713-8588
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
NC2021-02345207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program