Provider Demographics
NPI:1801387279
Name:HUBER, YOSEF YITZCHOK (MD)
Entity Type:Individual
Prefix:
First Name:YOSEF
Middle Name:YITZCHOK
Last Name:HUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:22255 GREENFIELD RD STE 280
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3712
Mailing Address - Country:US
Mailing Address - Phone:248-849-4990
Mailing Address - Fax:248-849-4991
Practice Address - Street 1:22255 GREENFIELD RD STE 280
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3712
Practice Address - Country:US
Practice Address - Phone:248-849-4990
Practice Address - Fax:248-849-4991
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301115096207R00000X
MI4301504575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine