Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 5101010627 | MI |
NPI | 1053458638 |
---|---|
Provider Name | Dr. Paul Howard Emerson |
First Address | Brownstown, MI 48174-9624 |
Second Address | Taylor, MI 48180-3910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |