Provider Demographics
NPI:1356638027
Name:BAJRIC, JASMINA (MD)
Entity Type:Individual
Prefix:DR
First Name:JASMINA
Middle Name:
Last Name:BAJRIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 LEONARD ST NE STE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-5807
Mailing Address - Country:US
Mailing Address - Phone:616-942-6687
Mailing Address - Fax:616-942-9797
Practice Address - Street 1:2757 LEONARD ST NE STE 300
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-5807
Practice Address - Country:US
Practice Address - Phone:616-942-6687
Practice Address - Fax:616-942-9797
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301504746207WX0200X, 207WX0200X
MN55211207W00000X
FL132483207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1356638027Medicaid
MNP01116671OtherRAILROAD MEDICARE
MNP01116671OtherRAILROAD MEDICARE