Provider Demographics
NPI:1548231129
Name:RASANSKY, MARC (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:RASANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 N 12TH ST
Mailing Address - Street 2:AURORA HEALTH CARE CENTER FOR SENIOR HEALTH & LONGEVITY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1308
Mailing Address - Country:US
Mailing Address - Phone:414-219-7300
Mailing Address - Fax:414-219-7632
Practice Address - Street 1:1020 N 12TH ST,
Practice Address - Street 2:AURORA HEALTH CARE CENTER FOR SENIOR HEALTH & LONGEVITY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-0342
Practice Address - Country:US
Practice Address - Phone:414-219-7300
Practice Address - Fax:414-219-7632
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22913207RC0200X, 207RP1001X, 207RS0012X
WI22913-20207RG0300X, 207RP1001X, 207RS0012X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1548231129Medicaid
WI001846210Medicare PIN
WI1548231129Medicaid