MEDICARE: HARVEY YOUSSEF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401415735	VA

General Provider Information

NPI Number	:	1245751841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARVEY YOUSSEF

Provider Business Mailing Address
First Line	:	11736 W BROAD ST STE 112
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-1189
Country	:	US
Telephone Number	:	804-360-8890
Fax Number	:	804-360-8894

Provider Business Practice Location Address
First Line	:	11736 W BROAD ST STE 112
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-1189
Country	:	US
Telephone Number	:	804-360-8890
Fax Number	:	804-360-8894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2017
Last Update Date	:	07/21/2022

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Directions to “ HARVEY YOUSSEF ” Practice Location

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