Provider Demographics
NPI:1780792291
Name:YOUSUF, MUSARRAT AFROZE (MD)
Entity type:Individual
Prefix:
First Name:MUSARRAT
Middle Name:AFROZE
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 1:300 SUN TEMPLE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-5919
Mailing Address - Country:US
Mailing Address - Phone:256-325-9111
Mailing Address - Fax:256-325-9113
Practice Address - Street 1:300 SUN TEMPLE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-5919
Practice Address - Country:US
Practice Address - Phone:256-325-9111
Practice Address - Fax:256-325-9113
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23512174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL98537Medicaid
AL98537Medicaid
ALH27037Medicare UPIN