Provider Demographics
NPI:1033310107
Name:NIGAR YOUSUF M.D. PLC
Entity Type:Organization
Organization Name:NIGAR YOUSUF M.D. PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:248-888-8582
Mailing Address - Street 1:26105 ORCHARD LAKE RD
Mailing Address - Street 2:109
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4576
Mailing Address - Country:US
Mailing Address - Phone:248-882-8582
Mailing Address - Fax:
Practice Address - Street 1:26105 ORCHARD LAKE RD
Practice Address - Street 2:109
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4576
Practice Address - Country:US
Practice Address - Phone:248-882-8582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINY0517912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MINY051791OtherSTATE LICENSE
MI0P62360Medicare PIN