Charles Gerard Emond Jr., D.O.
Individual provider Active NPI Emergency Medicine Physician · Fremont, MI
NPI 1801964747 · NPPES record last updated Dec 15, 2021
Key facts
- NPI
- 1801964747
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5101024489 (MI)
- Practice address
- 212 S Sullivan Ave
Fremont, MI 49412-1548 - Phone
- (866) 270-4203
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10377 | CA | MD | Optometrist |
| 20A10377 | CA | MD | Emergency Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 20A10377 | CA | |
| Emergency Medicine Physician | 207P00000X | 5101024489 | MI | Yes |
Addresses
Primary practice location
212 S Sullivan Ave
Fremont, MI 49412-1548
Mailing address
PO Box 22067
Lansing, MI 48909-2067
Phone (616) 975-1845
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Fremont, MI
- Derek Edlund
- Lara Ann Eenigenburg
- Chelsea Leigh Eglinton
- Vicky Lynn Eikenberry
- Cortney Ellis
- Jehanna Shaelah Erho
- Charles Merle Erickson
- Joni Lynn Erlewein
- Aaron Michael Evans
- Joshua Abrams Fair
All providers in Fremont, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.