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General NPI Number Information
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NPI Number | 1497789150
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Entity Type | Individual
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Provider Name | SEMBUA SAMUEL DANIELI MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 501 MORRIS ST
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City | CHARLESTON
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State | WV
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Zip | 25301-1326
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Country | US
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Telephone | 304-388-5432
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Fax |
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Provider Business Mailing Address
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Address Line | 400 ASSOCIATION DR STE 102
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City | CHARLESTON
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State | WV
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Zip | 25311-1298
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101236251
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2009-01523
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2009-01523
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 33148
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License Number State | WV
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