Individual
HENRY M JURASEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19020 FORT ST, RIVERVIEW, MI 48193-6701
(734) 362-5100
(734) 362-5147
Mailing address
19020 FORT ST, RIVERVIEW, MI 48193-6701
(734) 362-5100
(734) 362-5147
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301078292
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139214
MERCY CARE CHOICES
MI
01
—
16742
MCARE
MI
01
—
2418133
UHC
MI
01
—
4301078292
PHYSICIAN LICENSE
MI
05
—
4621093
—
MI
01
—
6684867
CIGNA
MI
01
—
700H21076
BCBSM
MI
01
—
7442675
AETNA
MI
01
—
CC3713
RR MEDICARE
MI
Enumeration date
05/15/2006
Last updated
02/17/2010
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