MEDICARE: EMERGENCY MEDICINE SPECIALISTS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	207P00000X	Emergency Medicine Physician

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

General Provider Information

NPI Number	:	1689062440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERGENCY MEDICINE SPECIALISTS, INC.

Provider Business Mailing Address
First Line	:	3131 NEWMARK DR STE 220
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-5400
Country	:	US
Telephone Number	:	937-436-4658
Fax Number	:	937-436-4984

Provider Business Practice Location Address
First Line	:	100 KETTERING WAY
Second Line	:
City	:	FRANKLIN
State	:	OH
Zip	:	45005-1155
Country	:	US
Telephone Number	:	937-458-4700
Fax Number	:	937-458-4737

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM BRADY
Credential	:	MD
Telephone Number	:	937-438-8910

Provider Enumeration Date	:	01/02/2015
Last Update Date	:	05/15/2024

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Directions to “EMERGENCY MEDICINE SPECIALISTS, INC. ” Practice Location

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