Provider Demographics
NPI:1487864765
Name:HAJYOUSEF, ABDASSALAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDASSALAM
Middle Name:
Last Name:HAJYOUSEF
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 1:901 KIMOLE LN STE B1
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1491
Mailing Address - Country:US
Mailing Address - Phone:517-263-6733
Mailing Address - Fax:517-263-7148
Practice Address - Street 1:901 KIMOLE LN STE B1
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1491
Practice Address - Country:US
Practice Address - Phone:517-263-6733
Practice Address - Fax:517-263-7148
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010853892080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine