Healthcare Provider Details

I. General information

NPI: 1255509626
Provider Name (Legal Business Name): MAROUN T SEMAAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 12/13/2020
Certification Date: 12/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE LKS 5045
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

26300 VILLAGE LN APT# 213
BEACHWOOD OH
44122-7565
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-5500
  • Fax:
Mailing address:
  • Phone: 216-342-4254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number35.093839
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35-093839
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: