Provider Demographics
NPI:1194881011
Name:YUSAF, PERVEZ (MD)
Entity type:Individual
Prefix:
First Name:PERVEZ
Middle Name:
Last Name:YUSAF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4677 TOWNE CENTRE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2846
Mailing Address - Country:US
Mailing Address - Phone:989-790-6719
Mailing Address - Fax:989-790-9464
Practice Address - Street 1:4677 TOWNE CENTRE RD FL 2
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2846
Practice Address - Country:US
Practice Address - Phone:989-790-6719
Practice Address - Fax:989-790-9464
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPY038356207X00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1099090Medicaid
MI0730155Medicare ID - Type Unspecified
MI1099090Medicaid