Healthcare Provider Details

I. General information

NPI: 1962421198
Provider Name (Legal Business Name): SENAD CEMERLIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 S STATE ST
DOVER DE
19901-5148
US

IV. Provider business mailing address

17 PENNWOOD DR
DOVER DE
19901-5848
US

V. Phone/Fax

Practice location:
  • Phone: 302-526-2770
  • Fax: 302-526-2954
Mailing address:
  • Phone: 302-423-0954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number234695
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number234695
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number234695
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number234695
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number234695
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: