Healthcare Provider Details

I. General information

NPI: 1962930396
Provider Name (Legal Business Name): SEMPER HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 GALLANT FOX LN STE 210B
BOWIE MD
20715-4033
US

IV. Provider business mailing address

2805 ADVENT CT N
BOWIE MD
20716-1327
US

V. Phone/Fax

Practice location:
  • Phone: 301-363-0997
  • Fax:
Mailing address:
  • Phone: 301-523-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberRN1007259
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberR080218
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR080218
License Number StateMD

VIII. Authorized Official

Name: DR. SANDRA L O'BRIEN
Title or Position: CO-OWNER
Credential: CRNP-F
Phone: 301-523-8828