MEDICARE: NIGAR YOUSUF M.D. PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	NY051791	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NY051791	OTHER	MI	STATE LICENSE

General Provider Information

NPI Number	:	1033310107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIGAR YOUSUF M.D. PLC

Provider Business Mailing Address
First Line	:	26105 ORCHARD LAKE RD
Second Line	:	109
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-4576
Country	:	US
Telephone Number	:	248-882-8582
Fax Number	:

Provider Business Practice Location Address
First Line	:	26105 ORCHARD LAKE RD
Second Line	:	109
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-4576
Country	:	US
Telephone Number	:	248-882-8582
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NIGAR YOUSUF
Credential	:	M D
Telephone Number	:	248-888-8582

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	12/31/2008

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