Provider Demographics
NPI:1063827236
Name:KORMAN, EMILY (DO)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KORMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3290 42ND AVE S
Mailing Address - Street 2:STE 100
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-6251
Mailing Address - Country:US
Mailing Address - Phone:320-227-5010
Mailing Address - Fax:320-227-5025
Practice Address - Street 1:111 2ND ST S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-1917
Practice Address - Country:US
Practice Address - Phone:320-281-3339
Practice Address - Fax:320-200-7505
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAR-10086208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics