Provider Demographics
NPI:1457441784
Name:QUASARANO, RAYMOND T (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:T
Last Name:QUASARANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39200 GARFIELD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4095
Mailing Address - Country:US
Mailing Address - Phone:586-286-6060
Mailing Address - Fax:586-286-5055
Practice Address - Street 1:39200 GARFIELD RD
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-4095
Practice Address - Country:US
Practice Address - Phone:586-286-6060
Practice Address - Fax:586-286-5055
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIRQ061374207V00000X
MI4301061374207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3373965Medicaid
MI1992895221OtherPRACTICE NPI
MIRQ061374OtherBCBS
MI1750415915OtherPRACTICE NPI