Healthcare Provider Details

I. General information

NPI: 1568037497
Provider Name (Legal Business Name): YOUSIF KESSAR TAWADROS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 HALLMARK CT
SAGINAW MI
48603-2109
US

IV. Provider business mailing address

1000 HOUGHTON AVE
SAGINAW MI
48602-5303
US

V. Phone/Fax

Practice location:
  • Phone: 989-790-5990
  • Fax:
Mailing address:
  • Phone: 989-558-6425
  • Fax: 989-746-7723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5101028323
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number5101028323
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: