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General NPI Number Information
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NPI Number | 1376357012
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Entity Type | Organization
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Legal Business Name | SKIN LAB BY DR YOUSIF PLLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1551 W BIG BEAVER RD STE D16
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City | TROY
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State | MI
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Zip | 48084-3528
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Country | US
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Telephone | 248-961-0294
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 W BIG BEAVER RD STE D16
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City | TROY
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State | MI
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Zip | 48084-3528
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Country | US
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Telephone | 248-961-0294
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | JAMES J YOUSIF
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Credential | DO
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Telephone | 248-961-0294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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