Provider Demographics
NPI:1720080385
Name:RIZK, YOUSSEF S (DO)
Entity Type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:S
Last Name:RIZK
Suffix:
Gender:M
Credentials:DO
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Other - Last Name:
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Mailing Address - Street 1:22201 MOROSS RD
Mailing Address - Street 2:STE 150
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2169
Mailing Address - Country:US
Mailing Address - Phone:313-886-8787
Mailing Address - Fax:313-886-4103
Practice Address - Street 1:22201 MOROSS RD
Practice Address - Street 2:STE 150
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2169
Practice Address - Country:US
Practice Address - Phone:313-886-8787
Practice Address - Fax:313-886-4103
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIYR0228872086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H06987Medicare UPIN