Provider Demographics
NPI:1356806152
Name:RASUL, JOJO-OUMA
Entity type:Individual
Prefix:
First Name:JOJO-OUMA
Middle Name:
Last Name:RASUL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JO
Other - Middle Name:O
Other - Last Name:RASUL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:22900 ALGER ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-3805
Mailing Address - Country:US
Mailing Address - Phone:313-421-5733
Mailing Address - Fax:
Practice Address - Street 1:22900 ALGER ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-3805
Practice Address - Country:US
Practice Address - Phone:313-421-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health