Healthcare Provider Details

I. General information

NPI: 1558034280
Provider Name (Legal Business Name): PETRO YOUSEF M.D., C.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 13TH ST W
HAVRE MT
59501-5215
US

IV. Provider business mailing address

PO BOX 1231
HAVRE MT
59501-1231
US

V. Phone/Fax

Practice location:
  • Phone: 406-265-7831
  • Fax:
Mailing address:
  • Phone: 406-262-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number118323
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: