Individual
DR. ALEXANDER M TASSOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3750
(414) 259-9290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301500990
MI
2085R0202X
Diagnostic Radiology Physician
61774
WI
2085R0202X
Diagnostic Radiology Physician
A146883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477829760
—
WI
Enumeration date
03/30/2012
Last updated
03/24/2022
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