Provider Demographics
NPI:1376357012
Name:SKIN LAB BY DR YOUSIF PLLC
Entity type:Organization
Organization Name:SKIN LAB BY DR YOUSIF PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:YOUSIF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-961-0294
Mailing Address - Street 1:1551 W BIG BEAVER RD STE D16
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3528
Mailing Address - Country:US
Mailing Address - Phone:248-961-0294
Mailing Address - Fax:
Practice Address - Street 1:1551 W BIG BEAVER RD STE D16
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3528
Practice Address - Country:US
Practice Address - Phone:248-961-0294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty