Provider Demographics
NPI:1336456896
Name:NASHWAN YOUSIF MD PLLC
Entity Type:Organization
Organization Name:NASHWAN YOUSIF MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-495-1010
Mailing Address - Street 1:PO BOX 4304
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-4304
Mailing Address - Country:US
Mailing Address - Phone:248-693-8634
Mailing Address - Fax:248-693-8644
Practice Address - Street 1:1261 S LAPEER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1419
Practice Address - Country:US
Practice Address - Phone:248-693-8634
Practice Address - Fax:248-693-8644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-04
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080432207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty