Provider Demographics
NPI:1235416553
Name:YOUKHANNA, JOSEPH SAMUEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SAMUEL
Last Name:YOUKHANNA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38270 STEEDE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3069
Mailing Address - Country:US
Mailing Address - Phone:586-202-2287
Mailing Address - Fax:
Practice Address - Street 1:1965 E BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-2006
Practice Address - Country:US
Practice Address - Phone:248-526-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist