Provider Demographics
NPI:1497301121
Name:DYER, EMILY ANN
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:DYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-5048
Mailing Address - Country:US
Mailing Address - Phone:336-334-5000
Mailing Address - Fax:
Practice Address - Street 1:246 MOUNTAIN SHADOWS DR
Practice Address - Street 2:
Practice Address - City:PURLEAR
Practice Address - State:NC
Practice Address - Zip Code:28665-9400
Practice Address - Country:US
Practice Address - Phone:336-907-6812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program