Provider Demographics
NPI:1649262353
Name:LIMCHOA, EMILIO (MD)
Entity type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:
Last Name:LIMCHOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24381 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1917
Mailing Address - Country:US
Mailing Address - Phone:248-477-4407
Mailing Address - Fax:248-477-4457
Practice Address - Street 1:24381 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1917
Practice Address - Country:US
Practice Address - Phone:248-477-4407
Practice Address - Fax:248-477-4457
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4285731-10Medicaid
MI4285731-10Medicaid