MEDICARE: SHOBHA SEM M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	C1-0005822	DE

General Provider Information

NPI Number	:	1336124452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHOBHA SEM M.D

Provider Business Mailing Address
First Line	:	PSC80,BOX13453
Second Line	:	APO,AP,96367
City	:	KADENA AB
State	:	OKINAWA
Zip	:	96367
Country	:	JP
Telephone Number	:	11-630-4305
Fax Number	:	315-630-4230

Provider Business Practice Location Address
First Line	:	PSC80,BOX13453
Second Line	:	APO,AP,96367
City	:	KADENA AB
State	:	OKINAWA
Zip	:	96367
Country	:	JP
Telephone Number	:	11-630-4305
Fax Number	:	315-630-4230

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	07/21/2022

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