Healthcare Provider Details
I. General information
NPI: 1124004908
Provider Name (Legal Business Name): R STEVEN HEMBY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/22/2005
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 N PERRY ST
PONTIAC MI
48342-2217
US
IV. Provider business mailing address
50 N PERRY ST
PONTIAC MI
48342-2217
US
V. Phone/Fax
- Phone: 248-338-5327
- Fax: 248-338-5129
- Phone: 248-338-5327
- Fax: 248-338-5129
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | 5101011995 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 036146433 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: