Provider Demographics
NPI:1093769192
Name:YOUNG, BRIAN D (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:37399 GARFIELD RD STE 106
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3672
Mailing Address - Country:US
Mailing Address - Phone:586-226-3500
Mailing Address - Fax:586-226-3600
Practice Address - Street 1:46857 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5225
Practice Address - Country:US
Practice Address - Phone:586-532-8500
Practice Address - Fax:586-532-1515
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIBY013152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1093769192Medicaid
MI0P12690Medicare ID - Type UnspecifiedMEDICARE GROUP