Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 5101011705 | MI |
NPI | 1003819897 |
---|---|
Provider Name | Dr. Anthony A Emmer |
First Address | Southfield, MI 48034-1753 |
Second Address | Southfield, MI 48034-1753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G22868 | (02) | MI |