Provider Demographics
NPI:1649838244
Name:DUSAJ, JUSTIN LEE (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:LEE
Last Name:DUSAJ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:965 WILSON RD RM A233
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-6410
Mailing Address - Country:US
Mailing Address - Phone:517-364-7650
Mailing Address - Fax:
Practice Address - Street 1:965 WILSON RD
Practice Address - Street 2:ROOM A233
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6410
Practice Address - Country:US
Practice Address - Phone:517-353-4362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51510137052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry