Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 36111 | WI |
NPI | 1063514164 |
---|---|
Provider Name | Mark E Rassier |
First Address | Marshfield, WI 54449-5777 |
Second Address | Minocqua, WI 54548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 30/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32091900 | (05) | WI |
E63801 | (02) |