MEDICARE: HANY YOUSSEF FARAG MEKHAEL MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	4301080242	MI
2	2084P0800X	Psychiatry Physician	4301080242	MI

General Provider Information

NPI Number	:	1396709259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANY YOUSSEF FARAG MEKHAEL MD

Provider Business Mailing Address
First Line	:	43200 DEQUINDRE RD
Second Line	:	STE 104
City	:	STERLING HTS
State	:	MI
Zip	:	48314-1707
Country	:	US
Telephone Number	:	586-799-4350
Fax Number	:	586-799-4279

Provider Business Practice Location Address
First Line	:	906 MAJESTIC
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-3575
Country	:	US
Telephone Number	:	810-794-7750
Fax Number	:	844-269-7554

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

Provider Enumeration Date	:	04/16/2006
Last Update Date	:	03/13/2024

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