MEDICARE: DR. STEPHEN WAYNE EMERICK PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4189	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184608523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN WAYNE EMERICK PH.D.

Provider Business Mailing Address
First Line	:	9863 ARN DR
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-4144
Country	:	US
Telephone Number	:	937-271-9560
Fax Number	:

Provider Business Practice Location Address
First Line	:	9863 ARN DR
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-4144
Country	:	US
Telephone Number	:	937-271-9560
Fax Number	:	937-439-3747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	06/26/2024

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Directions to “ DR. STEPHEN WAYNE EMERICK PH.D.” Practice Location

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