Healthcare Provider Details

I. General information

NPI: 1699749333
Provider Name (Legal Business Name): SEMAAN Y EL-KHOURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 01/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 HOLLOWELL ROAD
AULANDER NC
27805-0309
US

IV. Provider business mailing address

PO BOX 309
AULANDER NC
27805-0309
US

V. Phone/Fax

Practice location:
  • Phone: 252-345-3791
  • Fax: 252-345-0480
Mailing address:
  • Phone: 252-345-3791
  • Fax: 252-345-0480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number9601299
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9601299
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: