Organization
CERTIFIED EMERGENCY MEDICINE SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SONYA D WILSON (PROVIDER CREDENTIALING)
(616) 363-7867
Entity
Organization
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519
(616) 363-7867
(616) 363-9432
Mailing address
PO BOX 72011, CLEVELAND, OH 44192-0002
(616) 363-7867
(616) 363-9432
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002854
COMMUNITY HEALTH PLANS
MI
01
—
9300412441
RAILROAD MEDICARE
MI
Enumeration date
12/06/2006
Last updated
03/14/2017
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