Provider Demographics
NPI:1902968290
Name:SHEMANSIK, CARMELLA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:CARMELLA
Middle Name:ROSE
Last Name:SHEMANSIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-0035
Mailing Address - Country:US
Mailing Address - Phone:412-937-5700
Mailing Address - Fax:
Practice Address - Street 1:420 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3625
Practice Address - Country:US
Practice Address - Phone:570-621-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD436227207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA126173OtherGEISINGER
PAP00736827OtherRR MEDICARE
PA1023070000001Medicaid
PA2101305OtherHIGHMARK
PA50086131OtherCAPITAL BLUE CROSS
PAP00732738OtherRR MEDICARE
PAP00732738OtherRR MEDICARE
PA2101305OtherHIGHMARK