Healthcare Provider Details

I. General information

NPI: 1780811240
Provider Name (Legal Business Name): SHERI L EMMONS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26211 CENTRAL PARK BLVD STE 375
SOUTHFIELD MI
48076-4157
US

IV. Provider business mailing address

26211 CENTRAL PARK BLVD STE 375
SOUTHFIELD MI
48076-4157
US

V. Phone/Fax

Practice location:
  • Phone: 248-233-3795
  • Fax:
Mailing address:
  • Phone: 248-233-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: