Individual
MARY ANN RASKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6566
(414) 454-6522
Mailing address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6566
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
65713-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487915237
—
WI
Enumeration date
06/07/2012
Last updated
07/27/2016
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