Healthcare Provider Details

I. General information

NPI: 1174050231
Provider Name (Legal Business Name): YOUSEF BADER MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24623 GREENFIELD RD
SOUTHFIELD MI
48075-3058
US

IV. Provider business mailing address

5280 METROPOLITAN PKWY
STERLING HEIGHTS MI
48310-4005
US

V. Phone/Fax

Practice location:
  • Phone: 248-557-9010
  • Fax: 248-557-3655
Mailing address:
  • Phone: 248-290-3111
  • Fax: 248-290-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number4301500738
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301500738
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: