Organization
EMERGENCY MEDICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY HODGE DO (PRESIDENT)
(517) 337-0957
Entity
Organization
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48909
(517) 336-8080
(517) 336-9122
Mailing address
PO BOX 634280, CINCINNATI, OH 45263-4280
(517) 337-0957
(517) 336-9122
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010C376260
BLUE CROSS BLUE SHIELD
MI
01
—
0C37626
BLUE CROSS BLUE SHIELD
MI
01
—
1003128
MCLAREN
MI
01
—
CK0330
RAILROAD MEDICARE
MI
Enumeration date
12/28/2005
Last updated
10/03/2014
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