Provider Demographics
NPI:1528578952
Name:RAYMOND, EMILY ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:29992 NORTHWESTERN HWY STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1430
Mailing Address - Fax:248-851-5182
Practice Address - Street 1:3577 W 13 MILE RD STE 204
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-551-2446
Practice Address - Fax:248-551-1094
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2019-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601008316363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant