Provider Demographics
NPI:1336769793
Name:TRENTACOSTA, EMMA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:LYNN
Last Name:TRENTACOSTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMMA
Other - Middle Name:LYNN
Other - Last Name:HERRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16001 WEST NINE MILD RD.
Mailing Address - Street 2:FISHER BUILDING SUITE 401
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3707
Mailing Address - Country:US
Mailing Address - Phone:248-849-3541
Mailing Address - Fax:248-849-2899
Practice Address - Street 1:16001 W 9 MILE RD BLDG SUITE401
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-3541
Practice Address - Fax:248-849-2899
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351046220207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology