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Individual
SUSAN JURASEK
Active
Individual
SUSAN JURASEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301076380
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136932
MERCY CARE CHOICES
MI
01
—
16362
MCARE
MI
01
—
2366034
UHC
MI
01
—
4301076380
PHYSICIAN LICENSE
MI
05
—
4621100
—
MI
01
—
6675152
CIGNA
MI
01
—
700H21076
BCBSM
MI
01
—
7160529
AETNA
MI
01
—
CC3713
RR MEDICARE
MI
Enumeration date
05/16/2006
Last updated
02/17/2010
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