Provider Demographics
NPI:1013935568
Name:GORIEL, YOUSIF H (MD)
Entity Type:Individual
Prefix:
First Name:YOUSIF
Middle Name:H
Last Name:GORIEL
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 1:15351 W NINE MILE RD
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237
Mailing Address - Country:US
Mailing Address - Phone:248-968-9500
Mailing Address - Fax:248-968-9502
Practice Address - Street 1:15351 W NINE MILE RD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237
Practice Address - Country:US
Practice Address - Phone:248-968-9500
Practice Address - Fax:248-968-9502
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301034445208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3069901Medicaid
MI3069901Medicaid
B43357Medicare UPIN