Provider Demographics
NPI:1306929427
Name:EMERSON, NORMAN DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:DAVID
Last Name:EMERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12719 STOTTLEMYER RD
Mailing Address - Street 2:
Mailing Address - City:MYERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21773-9727
Mailing Address - Country:US
Mailing Address - Phone:580-319-8457
Mailing Address - Fax:301-965-8727
Practice Address - Street 1:12719 STOTTLEMYER RD
Practice Address - Street 2:
Practice Address - City:MYERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21773-9727
Practice Address - Country:US
Practice Address - Phone:580-319-8457
Practice Address - Fax:301-965-8727
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101261544207R00000X
MDD0077952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200006840AMedicaid
OK248303005Medicare PIN
F34761Medicare UPIN