Individual
EMILY DEDOYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
35 MICHIGAN ST NE STE 3003, GRAND RAPIDS, MI 49503-2528
(616) 267-2500
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012235
MI
Other
Enumeration date
01/29/2024
Last updated
04/29/2024
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