Healthcare Provider Details

I. General information

NPI: 1922235563
Provider Name (Legal Business Name): ADEEL YOUSAF M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2009
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 MAIN ST SUITE C
DOWAGIAC MI
49047-1762
US

IV. Provider business mailing address

101 MANNING DR SUITE C
CHAPEL HILL NC
27514-4220
US

V. Phone/Fax

Practice location:
  • Phone: 268-783-2080
  • Fax:
Mailing address:
  • Phone: 268-783-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301102599
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: