Provider Demographics
NPI:1336226919
Name:YOUSUF, NIGAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NIGAR
Middle Name:
Last Name:YOUSUF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26105 ORCHARD LAKE RD
Mailing Address - Street 2:STE#101
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4576
Mailing Address - Country:US
Mailing Address - Phone:248-888-8582
Mailing Address - Fax:248-888-8583
Practice Address - Street 1:26105 ORCHARD LAKE RD
Practice Address - Street 2:STE#101
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4576
Practice Address - Country:US
Practice Address - Phone:248-888-8582
Practice Address - Fax:248-888-8583
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010517912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2606347471OtherBLUE CROSS BLUE SHEILD #
MI4708293Medicaid
MI2606347471OtherBLUE CROSS BLUE SHEILD #
MIOM91530Medicare ID - Type UnspecifiedMEDICARE #