Provider Demographics
NPI:1770564072
Name:VASIU, SAMUEL II (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:VASIU
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 BYRON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1077
Mailing Address - Country:US
Mailing Address - Phone:517-548-9200
Mailing Address - Fax:517-548-2689
Practice Address - Street 1:1320 BYRON RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1077
Practice Address - Country:US
Practice Address - Phone:517-548-9200
Practice Address - Fax:517-548-2689
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI006085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1023082Medicaid
E26786Medicare UPIN
MI2688001Medicare PIN