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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JEREMIAH BACALSO DUCUSIN, PA-C

Active

JEREMIAH BACALSO DUCUSIN, PA-C is a Medical Physician Assistant healthcare provider located in CLINTON TOWNSHIP, Michigan. NPI 1164173001 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · CLINTON TOWNSHIP, MI

Registration Details

NPI Number
1164173001
Provider Type
Individual
Gender
Male
NPI Issued
Jan 12, 2022 (4.5570391514372 yrs)
Last Updated
Jan 12, 2022

Practice Information

Address
15855 19 MILE RD
CLINTON TOWNSHIP, MI, 480383504
Browse MI providers · Browse ZIP 48038
Phone
5862632300
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in CLINTON TOWNSHIP, MI

Name Credential NPI
SHANNON WASMUND PA 1154371409
MS. THERESA STEPHANINE JONES M.S. PA C 1376552877
MISS RADHA SAMPAT PA-C 1801190913
MS. RACHEL RENEE MACKMIN PA-C 1760018808
EMAN IMRAN PA-C 1952115065
KIMBERLEE MOLNAR CMA 1023814274
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.