Provider Demographics
NPI:1952385098
Name:YOUNAN, SILVANA PUTROUS (MD)
Entity Type:Individual
Prefix:DR
First Name:SILVANA
Middle Name:PUTROUS
Last Name:YOUNAN
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 1:27970 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3767
Mailing Address - Country:US
Mailing Address - Phone:248-626-1999
Mailing Address - Fax:248-626-7555
Practice Address - Street 1:27970 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3767
Practice Address - Country:US
Practice Address - Phone:248-626-1999
Practice Address - Fax:248-626-7555
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1952385098Medicaid
MI141162OtherCARE-PREFERRED CHOICES
MI146798OtherGREAT LAKES HEALTH PLAN
MI700F310000OtherBLUE SHIELD
MII18133OtherHAP
MII18133OtherHAP
MI146798OtherGREAT LAKES HEALTH PLAN