MEDICARE: DR. RANDY SEMMA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO3617	FL
2	213E00000X	Podiatrist	5901002563	MI
3	213ES0103X	Foot & Ankle Surgery Podiatrist	5901002563	MI

General Provider Information

NPI Number	:	1386933125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDY SEMMA DPM

Provider Business Mailing Address
First Line	:	1001 WELCH RD
Second Line	:	SUITE 110
City	:	COMMERCE TWP
State	:	MI
Zip	:	48390-2864
Country	:	US
Telephone Number	:	248-956-0177
Fax Number	:	248-694-2102

Provider Business Practice Location Address
First Line	:	1001 WELCH RD
Second Line	:	SUITE 110
City	:	COMMERCE TWP
State	:	MI
Zip	:	48390-2864
Country	:	US
Telephone Number	:	248-056-0177
Fax Number	:	248-694-2102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2011
Last Update Date	:	08/01/2015

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Directions to “ DR. RANDY SEMMA DPM” Practice Location

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