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NPI Code Detail

MEDICARE: MIRANDA YOUSEF

MEDICARE: MIRANDA YOUSEF
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1396560306
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA YOUSEF
Provider Business Mailing Address
First Line : 2095 E BIG BEAVER RD STE 375
Second Line :
City : TROY
State : MI
Zip : 48083-2374
Country : US
Telephone Number : 248-963-1124
Fax Number : 248-509-7022
Provider Business Practice Location Address
First Line : 2095 E BIG BEAVER RD STE 375
Second Line :
City : TROY
State : MI
Zip : 48083-2374
Country : US
Telephone Number : 248-963-1124
Fax Number : 248-509-7022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2024
Last Update Date : 09/04/2025

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Directions to “ MIRANDA YOUSEF ” Practice Location

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