Provider Demographics
NPI:1598853889
Name:SAMINA YOUSUF MD PC
Entity Type:Organization
Organization Name:SAMINA YOUSUF MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-889-0433
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-0128
Mailing Address - Country:US
Mailing Address - Phone:276-889-0433
Mailing Address - Fax:276-889-5537
Practice Address - Street 1:383 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-4632
Practice Address - Country:US
Practice Address - Phone:276-889-0433
Practice Address - Fax:276-889-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA177346OtherBLUE CROSS
VA382745OtherBLUE CROSS
VA238285OtherBLUE CROSS
VA248640OtherBLUE CROSS
VA176423OtherBLUE CROSS
VA384760OtherBLUE CROSS
VA174348OtherBLUE CROSS
VA174349OtherBLUE CROSS
VAFEDERAL BLACK LUNGOther01008700
VA248639OtherBLUE CROSS
VA382745OtherBLUE CROSS
VAFEDERAL BLACK LUNGOther01008700
VA248640OtherBLUE CROSS