Healthcare Provider Details

I. General information

NPI: 1972650455
Provider Name (Legal Business Name): ELMIR SEHIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 05/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MAIN STREET
DENNIS MA
02638-2159
US

IV. Provider business mailing address

PO BOX 2025
DENNIS MA
02638-5025
US

V. Phone/Fax

Practice location:
  • Phone: 508-385-4800
  • Fax: 508-385-4844
Mailing address:
  • Phone: 508-385-4800
  • Fax: 508-385-4844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number209522
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: