Provider Demographics
NPI:1134366149
Name:SEMON, GREGORY R (DO)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:R
Last Name:SEMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:128 E APPLE ST
Mailing Address - Street 2:SUITE 7000
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2902
Mailing Address - Country:US
Mailing Address - Phone:937-208-8322
Mailing Address - Fax:937-208-2105
Practice Address - Street 1:30 E APPLE ST
Practice Address - Street 2:SUITE 5253
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2939
Practice Address - Country:US
Practice Address - Phone:937-208-2552
Practice Address - Fax:937-208-4286
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2022-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.011898208600000X
FLTRN UO 3688390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery