MEDICARE: GARY H EMERSON MD

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	207V00000X	Obstetrics & Gynecology Physician	23253	SC

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	:	1770556169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY H EMERSON MD

Provider Business Mailing Address
First Line	:	PO BOX 3239
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29502-3239
Country	:	US
Telephone Number	:	843-656-2223
Fax Number	:	843-656-2242

Provider Business Practice Location Address
First Line	:	101 WILLIAM H. JOHNSON STREET
Second Line	:	SUITE 500
City	:	FLORENCE
State	:	SC
Zip	:	29506-2772
Country	:	US
Telephone Number	:	843-777-7400
Fax Number	:	843-777-7440

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	12/31/2018

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Directions to “ GARY H EMERSON MD” Practice Location

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