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General NPI Number Information
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NPI Number | 1720368996
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Entity Type | Individual
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Provider Name | EMILY H HAMAMDJIAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 4201 SAINT ANTOINE ST
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 952-442-9770
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Fax | 952-442-3620
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Provider Business Mailing Address
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Address Line | DEPARTMENT 4676
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City | CAROL STREAM
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State | IL
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Zip | 60122-4676
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Country | US
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Telephone | 888-278-4126
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Fax | 952-442-3620
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704253775
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License Number State | MI
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