Basic Information
Provider Information
NPI: 1972988194
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EMIGH
FirstName: STEPHEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DACM, AP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13000 BRUCE B DOWNS BLVD
Address2:  
City: TAMPA
State: FL
PostalCode: 336124745
CountryCode: US
TelephoneNumber: 8139722000
FaxNumber:  
Practice Location
Address1: 13000 BRUCE B DOWNS BLVD
Address2:  
City: TAMPA
State: FL
PostalCode: 336124745
CountryCode: US
TelephoneNumber: 8139722000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/29/2015
LastUpdateDate: 08/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171100000XAP3628FLY Other Service ProvidersAcupuncturist 

No ID Information.


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