Provider Demographics
NPI:1437201217
Name:YOUSIF, DHIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:DHIA
Middle Name:L
Last Name:YOUSIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28437 GREENFIELD RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-7164
Mailing Address - Country:US
Mailing Address - Phone:248-557-5888
Mailing Address - Fax:248-557-5877
Practice Address - Street 1:28437 GREENFIELD RD STE 102
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-7164
Practice Address - Country:US
Practice Address - Phone:248-557-5888
Practice Address - Fax:248-557-5877
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048281207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3380692Medicaid
MI3380692Medicaid
MIF33253Medicare UPIN