Provider Demographics
NPI:1497517726
Name:EMERSON, MAURICE SR
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:EMERSON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MAURICE
Other - Middle Name:
Other - Last Name:EMERSON
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14705 REDDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-3219
Mailing Address - Country:US
Mailing Address - Phone:216-463-1354
Mailing Address - Fax:
Practice Address - Street 1:14705 REDDINGTON AVE
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-3219
Practice Address - Country:US
Practice Address - Phone:216-463-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health