Provider Demographics
NPI:1679531446
Name:QUASNEY, MICHAEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:QUASNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DRIVE
Practice Address - Street 2:12TH FLOOR C.S MOTT CHILDREN'S HOSPITAL ROOM 525
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4280
Practice Address - Country:US
Practice Address - Phone:734-763-5302
Practice Address - Fax:734-232-4683
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN210712080P0203X
WI497452080P0203X
MI43011019212080P0203X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3088984Medicaid
3088987Medicare ID - Type Unspecified
TN3088984Medicaid