Healthcare Provider Details

I. General information

NPI: 1720032410
Provider Name (Legal Business Name): JOSEPH DRASBA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17717 MASONIC
FRASER MI
48026-3158
US

IV. Provider business mailing address

17717 MASONIC
FRASER MI
48026-3158
US

V. Phone/Fax

Practice location:
  • Phone: 586-294-0600
  • Fax:
Mailing address:
  • Phone: 586-294-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101006781
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: