Provider Demographics
NPI:1902923733
Name:RASANSKY, MICHAEL JORDAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JORDAN
Last Name:RASANSKY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:8950 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-8399
Mailing Address - Country:US
Mailing Address - Phone:313-295-3937
Mailing Address - Fax:313-295-2006
Practice Address - Street 1:8950 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-8399
Practice Address - Country:US
Practice Address - Phone:313-295-3937
Practice Address - Fax:313-295-2006
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016980207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology