Healthcare Provider Details

I. General information

NPI: 1417519463
Provider Name (Legal Business Name): NOURA SEMREEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2019
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 MEREDYTH DR
ALBANY GA
31707-2267
US

IV. Provider business mailing address

100 WOODS RD # C343
VALHALLA NY
10595-1530
US

V. Phone/Fax

Practice location:
  • Phone: 229-430-9223
  • Fax:
Mailing address:
  • Phone: 914-493-6610
  • Fax: 914-493-7506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number98721
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: