Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 4301110617 | MI |
NPI | 1417216896 |
---|---|
Provider Name | Emily English |
First Address | Wyoming, MI 49519-9686 |
Second Address | Grand Rapids, MI 49546-2149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2012 |
Last Update Date | 24/03/2020 |