Provider Demographics
NPI:1346581832
Name:SETSUDA, JASON ALEXANDER (DO)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ALEXANDER
Last Name:SETSUDA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49175 WEST RD
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-3552
Mailing Address - Country:US
Mailing Address - Phone:616-443-1765
Mailing Address - Fax:
Practice Address - Street 1:49175 WEST RD
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-3552
Practice Address - Country:US
Practice Address - Phone:248-487-8686
Practice Address - Fax:248-694-2113
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020399207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice