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General NPI Number Information
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NPI Number | 1053458638
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Entity Type | Individual
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Provider Name | PAUL HOWARD EMERSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24118 GODDARD RD
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City | TAYLOR
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State | MI
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Zip | 48180-3910
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Country | US
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Telephone | 313-827-5173
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Fax | 313-827-5172
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Provider Business Mailing Address
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Address Line | 23432 MATTS DR
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City | BROWNSTOWN
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State | MI
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Zip | 48174-9624
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Country | US
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Telephone | 734-934-9200
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Fax | 313-827-5172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 5101010627
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License Number State | MI
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