Healthcare Provider Details

I. General information

NPI: 1497165393
Provider Name (Legal Business Name): EMILY TROY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BROWN RD
AUBURN HILLS MI
48326-1309
US

IV. Provider business mailing address

4112 OAKLAND RIDGE DR
LAKE ORION MI
48359-1751
US

V. Phone/Fax

Practice location:
  • Phone: 248-393-5133
  • Fax: 248-393-5165
Mailing address:
  • Phone: 248-343-3549
  • Fax: 248-393-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302028188
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: