Provider Demographics
NPI:1003185653
Name:YOUSIF GORIEL MD,PC
Entity type:Organization
Organization Name:YOUSIF GORIEL MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSIF
Authorized Official - Middle Name:HANNA
Authorized Official - Last Name:GORIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-968-9500
Mailing Address - Street 1:15351 W 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2514
Mailing Address - Country:US
Mailing Address - Phone:248-968-9500
Mailing Address - Fax:248-968-9502
Practice Address - Street 1:15351 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2514
Practice Address - Country:US
Practice Address - Phone:248-968-9500
Practice Address - Fax:248-968-9502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301034445208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty