Basic Information
Provider Information
NPI: 1134117393
EntityType: 2
ReplacementNPI:  
OrganizationName: EMERGENCY MEDICINE ASSOCIATES P.A., P.C.
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Mailing Information
Address1: 4535 DRESSLER RD NW
Address2:  
City: CANTON
State: OH
PostalCode: 447182545
CountryCode: US
TelephoneNumber: 3309944409
FaxNumber: 3304928489
Practice Location
Address1: 8118 GOOD LUCK RD
Address2:  
City: LANHAM
State: MD
PostalCode: 207063574
CountryCode: US
TelephoneNumber: 2406862300
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/12/2005
LastUpdateDate: 09/30/2022
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AuthorizedOfficialLastName: REESE
AuthorizedOfficialFirstName: MELISSA
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AuthorizedOfficialTitleorPosition: PROVIDER ENROLLMENT OFFICER
AuthorizedOfficialTelephone: 8556870618
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 09/30/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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