Provider Demographics
NPI:1306951801
Name:DANESHVAR, YOUSEF (MD FACC)
Entity type:Individual
Prefix:DR
First Name:YOUSEF
Middle Name:
Last Name:DANESHVAR
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33433 6 MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3129
Mailing Address - Country:US
Mailing Address - Phone:734-525-3330
Mailing Address - Fax:734-525-3396
Practice Address - Street 1:33433 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3129
Practice Address - Country:US
Practice Address - Phone:734-525-3330
Practice Address - Fax:734-525-3396
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI036828207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104740307Medicaid
MI104740307Medicaid
B44156Medicare UPIN