Provider Demographics
NPI:1770922064
Name:GIULIANI, EMMA (MD)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:GIULIANI
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 1:3230 EAGLE PARK DR NE STE 102
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-7047
Mailing Address - Country:US
Mailing Address - Phone:877-904-4483
Mailing Address - Fax:
Practice Address - Street 1:3230 EAGLE PARK DR NE STE 102
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7047
Practice Address - Country:US
Practice Address - Phone:877-904-4483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301102997207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology