MEDICARE: DR. SUSAN YOUNGS 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	208000000X	Pediatrics Physician	4301061207	MI
2	2081P0010X	Pediatric Rehabilitation Medicine Physician	4301061207	MI

General Provider Information

NPI Number	:	1801865183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN YOUNGS MD

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 203
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:	947-522-0307
Fax Number	:	947-522-0307

Provider Business Practice Location Address
First Line	:	18501 ROTUNDA DR STE 200
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3891
Country	:	US
Telephone Number	:	313-996-1961
Fax Number	:

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	07/29/2022

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