Healthcare Provider Details

I. General information

NPI: 1639170632
Provider Name (Legal Business Name): MICHAEL SEKMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E LIBERTY ST SUITE B
GIRARD OH
44420-2418
US

IV. Provider business mailing address

1616 E LIBERTY ST SUITE B
GIRARD OH
44420-2418
US

V. Phone/Fax

Practice location:
  • Phone: 330-759-4733
  • Fax: 330-759-3527
Mailing address:
  • Phone: 330-759-4733
  • Fax: 330-759-3527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number35060366S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: