Provider Demographics
NPI:1144209420
Name:SEMAAN, HASSAN B (MD)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:B
Last Name:SEMAAN
Suffix:
Gender:M
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 5789
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-5789
Mailing Address - Country:US
Mailing Address - Phone:903-663-4800
Mailing Address - Fax:419-223-2726
Practice Address - Street 1:1600 E RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9805
Practice Address - Country:US
Practice Address - Phone:419-592-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010995232085R0202X
VA01012473692085R0202X
OH35.0775502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000347017OtherANTHEM BCBS
OHP00173502OtherRAILROAD MEDICARE
OH2182294Medicaid
MI1144209420Medicaid
OHSE4108584Medicare PIN
OH000000347017OtherANTHEM BCBS