Provider Demographics
NPI:1134414378
Name:YOUNG, BRIAN MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2046 BLUE LAC DR
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-9566
Mailing Address - Country:US
Mailing Address - Phone:517-339-0437
Mailing Address - Fax:
Practice Address - Street 1:2046 BLUE LAC DR
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-9566
Practice Address - Country:US
Practice Address - Phone:517-339-0437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019133207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine