Healthcare Provider Details

I. General information

NPI: 1518822006
Provider Name (Legal Business Name): CALVIN YOUSIF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30245 STERLING DR
NOVI MI
48377-3918
US

IV. Provider business mailing address

30245 STERLING DR
NOVI MI
48377-3918
US

V. Phone/Fax

Practice location:
  • Phone: 248-331-3497
  • Fax:
Mailing address:
  • Phone: 248-331-3497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304336
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: