Individual
TOM DAVID RAISANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 OSCEOLA ST, LAURIUM, MI 49913-2134
(906) 337-6560
Mailing address
50384 ROCKY SHORES RD, HOUGHTON, MI 49931-9213
(320) 267-4247
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301110056
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2016
Last updated
07/21/2020
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