Healthcare Provider Details

I. General information

NPI: 1952740656
Provider Name (Legal Business Name): EMERGENCY PROFESSIONALS OF MICHIGAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD BLVD
DEARBORN MI
48124-4089
US

IV. Provider business mailing address

PO BOX 638257
CINCINNATI OH
45263-8257
US

V. Phone/Fax

Practice location:
  • Phone: 856-848-3817
  • Fax:
Mailing address:
  • Phone: 856-848-3817
  • Fax: 856-848-8536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN J. MURTAUGH
Title or Position: CFO
Credential:
Phone: 856-848-3817