MEDICARE: EMMA ROSE RANDALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	4351049285	MI

General Provider Information

NPI Number	:	1265176127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA ROSE RANDALL MD

Provider Business Mailing Address
First Line	:	11300 E 13 MILE RD STE 4A
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48093-2500
Country	:	US
Telephone Number	:	586-574-1313
Fax Number	:

Provider Business Practice Location Address
First Line	:	11300 E 13 MILE RD STE 4A
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48093-2500
Country	:	US
Telephone Number	:	586-574-1313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	06/15/2026

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1437140704 — DR. JILL M PAGE MD
Practice Location Address:

11300 E 13 MILE RD , SUITE 4
WARREN, MI
48093-2500

Practice Phone: 586-574-1313
Practice Fax: 586-574-0842

1720060080 — DR. DEBORAH HARTMANN WOLFE MD
Practice Location Address:

11300 E 13 MILE RD , STE 4A
WARREN, MI
48093-2500

Practice Phone: 586-574-1313
Practice Fax: 586-574-0842

1285615575 — DR. KRISTEN E WUCKERT MD
Practice Location Address:

11300 E 13 MILE RD , STE 4A
WARREN, MI
48093-2500

Practice Phone: 586-574-1313
Practice Fax: 586-574-0842

1336120633 — DR. CAPRICE D MCGRAIL MD
Practice Location Address:

11300 E 13 MILE RD , STE 4A
WARREN, MI
48093-2500

Practice Phone: 586-574-1313
Practice Fax: 586-574-0842

1710961990 — DR. TARAS LISOWSKY D.O.
Practice Location Address:

11300 E 13 MILE RD STE 1
WARREN, MI
48093-2500

Practice Phone: 586-777-6170
Practice Fax: 586-777-6582

Directions to “ EMMA ROSE RANDALL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.