Most Relevant Information
Provider Data
| NPI Number: | 1003313370 |
| Provider Name: | EMILY MICHELLE GRAY |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0200X |
| Specialty: | Registered Nurse |
| License Number: | 704285810 |
Most Important Dates
| Enumeration Date: | 04/12/2018 |
| Last Updated: | 05/21/2019 |
Provider Practice Location
19725 W 12 MILE RD
SOUTHFIELD
MI
480762584
Practice Location Phone/Fax
| Phone: | 2486785117 |
| Fax: | 2486588777 |
Provider Mailing Location
30060 HATHAWAY ST
LIVONIA
MI
481503092
Provider Mailing Phone/Fax
| Phone: | 7345788074 |
| Fax: |