Individual
TERRENCE J EMILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1238 FULLER AVE NE, GRAND RAPIDS, MI 49505-5533
(616) 452-0467
(616) 452-8885
Mailing address
4310 LEONARD ST NW, SUITE 103, WALKER, MI 49534-8447
(616) 453-6329
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5901000775
MI
213E00000X
Podiatrist
Primary
5901000775
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1440263
—
MI
05
—
5106129
—
MI
Enumeration date
05/04/2006
Last updated
03/28/2012
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