Provider Demographics
NPI:1053458638
Name:EMERSON, PAUL HOWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HOWARD
Last Name:EMERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:23432 MATTS DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48174-9624
Mailing Address - Country:US
Mailing Address - Phone:734-934-9200
Mailing Address - Fax:313-827-5172
Practice Address - Street 1:24118 GODDARD RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3910
Practice Address - Country:US
Practice Address - Phone:313-827-5173
Practice Address - Fax:313-827-5172
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101010627207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine