Provider Demographics
NPI:1598728016
Name:HAMATI, YOUSIF I (MD)
Entity type:Individual
Prefix:
First Name:YOUSIF
Middle Name:I
Last Name:HAMATI
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 1:1400 MERCY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1836
Mailing Address - Country:US
Mailing Address - Phone:231-733-1326
Mailing Address - Fax:231-830-5212
Practice Address - Street 1:1400 MERCY DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1878
Practice Address - Country:US
Practice Address - Phone:231-733-1326
Practice Address - Fax:231-733-5212
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036132207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1790000Medicaid
MI4301036132OtherSTATE LICENSE
MIA77583Medicare UPIN
MI0613766Medicare ID - Type Unspecified