Provider Demographics
NPI:1164532685
Name:EMMI, ADELINA M (MD)
Entity Type:Individual
Prefix:
First Name:ADELINA
Middle Name:M
Last Name:EMMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MOBILE INFIRMARY CIR STE 213
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3514
Mailing Address - Country:US
Mailing Address - Phone:251-438-4200
Mailing Address - Fax:251-438-4211
Practice Address - Street 1:3 MOBILE INFIRMARY CIR STE 213
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3514
Practice Address - Country:US
Practice Address - Phone:251-438-4200
Practice Address - Fax:251-438-4211
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103769207VE0102X
AL38676207VE0102X
GA050013207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00090461AMedicaid
SCG50013Medicaid
GA16BDTWLMedicare ID - Type UnspecifiedGA MEDICARE #
SCG50013Medicaid
MI0P30630876Medicare PIN