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Emily Dedoyard

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

35 Michigan St NE Ste 3003, Grand Rapids, MI 49503-2528

PECOS Enrollment

Based on the most recent information from CMS, provider Emily Dedoyard is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:37 AM.

Profile Details

Provider ID
1154183648
Provider Type
Individual
Full Name
Dedoyard, Emily
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
1/29/2024
Last Updated
4/29/2024

Contact Information

Practice Location

35 Michigan St NE Ste 3003, Grand Rapids, MI 49503-2528

(616) 267-2500

Unlisted Fax

Mailing Location

100 Michigan St NE # Mc845, Grand Rapids, MI 49503-2560

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5601012235 Michigan

Emily Dedoyard

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Rasch, Leah

Charleston, Mary Elizabeth

Hohnstein, Chad

Joslyn, Lauren Machelle

Cerny, Ryan J

Brini, Cristina Lynn

Bertus, Sarah

Calkins, Laura Elizabeth

Meyer, Kylie

Kuiper, Benjamin Daniel