Provider Demographics
NPI:1043655012
Name:SMITH, EMILY CLARE-SHOWERMAN (DO)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CLARE-SHOWERMAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 JOLLY OAK RD
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3542
Mailing Address - Country:US
Mailing Address - Phone:517-975-9475
Mailing Address - Fax:517-913-4042
Practice Address - Street 1:2270 JOLLY OAK RD
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3542
Practice Address - Country:US
Practice Address - Phone:517-975-9475
Practice Address - Fax:517-913-4042
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020355207QH0002X, 207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine