Healthcare Provider Details

I. General information

NPI: 1912008368
Provider Name (Legal Business Name): AMY EMBREE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11554 HIGHLAND RD
HARTLAND MI
48353-2711
US

IV. Provider business mailing address

11554 HIGHLAND RD
HARTLAND MI
48353-2711
US

V. Phone/Fax

Practice location:
  • Phone: 810-632-0086
  • Fax: 810-632-0080
Mailing address:
  • Phone: 810-632-0086
  • Fax: 810-632-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101013117
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101013117
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: