Provider Demographics
NPI:1174513022
Name:SIMAAN, SIMONE M (DC)
Entity type:Individual
Prefix:DR
First Name:SIMONE
Middle Name:M
Last Name:SIMAAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-2104
Mailing Address - Country:US
Mailing Address - Phone:910-787-3668
Mailing Address - Fax:
Practice Address - Street 1:603 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NC
Practice Address - Zip Code:28398-2104
Practice Address - Country:US
Practice Address - Phone:336-632-0123
Practice Address - Fax:336-632-1194
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC020570857OtherTRICARE
NC085HCOtherBCBSNC
NC020570857OtherCNC
NC020570857OtherACN
NC89083HCMedicaid
NCC1606OtherMEDCOST