Healthcare Provider Details

I. General information

NPI: 1891788477
Provider Name (Legal Business Name): ADEL I YOUSSEF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 E MARKET ST
WARREN OH
44483-6613
US

IV. Provider business mailing address

PO BOX 72188
CLEVELAND OH
44192-0002
US

V. Phone/Fax

Practice location:
  • Phone: 330-399-7215
  • Fax: 330-399-2411
Mailing address:
  • Phone: 330-399-7215
  • Fax: 330-399-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35058015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: