Step 1 of 1

Join the EMI Network

Complete the form below to begin your application. Our team will review your information and contact you within 3-5 business days.

Before You Begin

Submission of this application does not guarantee acceptance into the EMI network. Approval is based on current network needs, credentialing verification, and available capacity in your area.

Practice Information

Tell us about your practice

Contact Information

Primary contact for this application

We'll use this email for all application communications

Provider Credentials

Your professional identification numbers

10 digits

9 digits

Practice Address

Where your practice is located

Separate counties with commas

Practice Details

Tell us about your specialization

Line of Business *
Age Group Seen *
Sub Specialty *

* Required fields

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Need help with your application?

Contact our team at info@myemifl.com